PROSPECTIVE COMPARATIVE STUDY BETWEEN TOPICAL 2% DILTIAZEM PLUS 2% LIGNOCAINE GEL WITH LATERAL SPHINCTEROTOMY AND SUBCUTANEOUS FISSURECTOMY TO TREAT CHRONIC FISSURE IN ANO
Main Article Content
Keywords
2%lignocaine, 2%Diltiazem, Chronic fissure in ano, Lateral internal sphincterotomy, Subcutaneous fissurectomy.
Abstract
Introduction: An anal fissure is characterized by an ulcer in the anoderm, typically located along the posterior midline, less commonly in the anterior midline, and rarely in the lateral regions of the anal canal. Treatment options vary and include non-invasive pharmacological therapies, lateral internal sphincterotomy (LIS), which is considered the gold standard, as well as newer approaches such as perineal support devices, Gonyautoxin injection, fissurectomy, fissurotomy, sphincterolysis, and flap procedures. The objective of this study was to compare the treatment outcomes of lateral internal sphincterotomy and subcutaneous fissurectomy with topical 2% Diltiazem plus 2% lignocaine gel in the management of chronic fissure in ano
Objective of the study
- To compare the effectiveness of topical 2% diltiazem plus 2% Lignocaine gel with lateral sphincterotomy and subcutaneous fissurectomy to treat chronic fissure in ano
Materials and methods:
Sixty patients with chronic fissure-in-ano attending the outpatient department of General Surgery at RAICHUR INSTITUTE OF MEDICAL SCIENCES,RAICHUR, during the period 1st June 2024 to 30th December 2024, were randomly selected and assigned into two groups: Group A (n=30), who underwent lateral internal sphincterotomy (control group), and Group B (n=30), who received subcutaneous fissurectomy combined with topical 2% diltiazem plus 2 % Lignocaine gel (test group)..
Results:
Group B patients had a significantly shorter mean duration of absenteeism (2.88 weeks) compared to those in Group A. Statistically significant differences between Group B and Group A were also observed in terms of pain relief (P < 0.0001), complication rates (P = 0.03), average duration of sitz baths (P < 0.0001), and absenteeism (P < 0.0001)
Interpretation &Conclusion:
Therefore, subcutaneous fissurectomy combined with topical 2% diltiazem plus 2% lignocaine gel presents a superior surgical alternative to conventional lateral internal sphincterotomy for the treatment of chronic anal fissure
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Dr. Manojkumar V
Assistant Professor, department of General Surgery.RAICHUR INSTITUTE OF MEDICAL SCIENCES, RAICHUR
Dr. Sri Guru
Assistant Professor, department of General Surgery.MYSORE MEDICAL COLLEGE AND RESEARCH INSTITUTE, MYSORE
Dr.Dhrubajyoti Dey
Senior Resident, Department of General surgery, MANDAKINI INSTITUTE OF MEDICAL SCIENCES AND HOSPITAL, RANAGHAT, WEST BENGAL.