Comparative Evaluation of Lateral Internal Anal Sphincterotomy and Botulinum Toxin Injection in the Management of Chronic Fissure in Ano
Mahalakshmi Nagarajan, R. Sivamarieswaran, Srikanth Thiyagarajan, Abhishek RejiAbstract
Background:
Chronic fissure-in-ano is a common anorectal condition characterized by severe pain and impaired quality of life, primarily due to sustained internal anal sphincter hypertonia and reduced anodermal blood flow.
Aim:
This study aimed to compare the clinical outcomes of lateral internal anal sphincterotomy and botulinum toxin injection in the management of chronic fissure-in-ano.
Materials and Methods:
This study was conducted in a tertiary care hospital and included 210 patients with chronic fissure in ano. Patients were randomized into two groups: Group A (lateral internal anal sphincterotomy,
Results:
Intraoperative blood loss and immediate postoperative pain were significantly higher in the lateral internal anal sphincterotomy group (
Conclusion:
Lateral internal anal sphincterotomy provides superior medium- and long-term outcomes in terms of pain relief, healing, effectiveness, and recurrence compared to botulinum toxin injection, with an acceptable and largely transient impact on continence.