European Journal of Molecular & Clinical Medicine

Background: An anal fissure is one of the common anorectal disease resulting from a split or tear in the anal canal's skin, it causes pain, bleeding and emotional stress. There are medical and surgical treatment available for treating anal fissures, this study was aimed to compare lord’s dilations and lateral internal sphincterotomy.
Methods: An observational study conducted in 64 patient general surgery department, all patients were treated by conservative management first and surgically if required. Lateral internal sphincterotomy or lord’s dilatation were performed among study subjects by randomised process. 
Results: Mean age of 64 study sample was 38.78 years (SD - 9.03 years), with 52 (81%) male and 12 (19%) female in study. All 64 subjects were treated by conservative first, while 54 (84.4%) required surgical management. There was no significant difference in mean duration of surgery, post-operative pain & duration of hospital stay between lords dilation lateral spinteretomy.
Conclusion: Conservative medical treatments are all effective methods that may reduce the need for surgery in many patients. Early pain alleviation and a high ulcer healing rate are provided by anal dilatation and lateral internal spinteretomy treatment, LIS is a safer option in terms of recurrence.

Anal fissure is one of the most common anorectal conditions encountered in clinical practice. Most patients experience anal pain with defecation and minor bright red rectal bleeding, allowing a focused history to direct the evaluation.
This was a prospective, randomized, controlled clinical study conducted on 90 consecutive patients who presented to the general surgery outpatient clinic of Al - Hilla teaching Hospital Babil, between June 2019 and July 2021 were diagnosed with  anal fissure.
Although various non-surgical and surgical treatment meth­ods have been used, an ideal treatment method for acute anal fissure is still debatable. The topical antimicrobial treatment with metronidazole in addition to conventional medical treat­ments is an effective, easy-to-use, safe, fast and comfortable practice that enables further reduction of anal fissure pain and increases the healing rate.

Background: Chronic anal fissures are harder to treat and surgery may be the best
option. The goal of surgery is to help the anal sphincter muscles relax which
reduces pain and spasms, allowing the fissure to heal. The aim of the present study
was to assess the Improving outcome of patients of chronic anal fissure. Patients
and methods: This clinical trial study was conducted in General Surgery
Department, Faculty of Medicine, Zagazig University on 18 chronic anal fissure
cases. All patients were subjected to full history taking, proper local examination
and baseline investigations. Anorectal manometry was performed for all patients
preoperatively. Then, bilateral segmental internal sphincterotomy was done for all
patients. Results: In our study, age was 37.77 ± 6.44 with minimum of 24 and
maximum of 50 years. Regard sex distribution, males and females were matched
(50/50 percentage). Majority were posterior (66.7%) then anterior (22.2%) and
finally both (11.1%). Operation time was 17.77 ± 3.62 with minimum of 12 and
maximum of 25 minutes. After internal sphincterotomy, complete healing was
5.16±1.09 with minimum of 4 and maximum of 7 weeks. VAS significantly
decreased from pre to 1st 24 hours till the end of follow up. Incontinence score
significantly decreased from preoperatively to 1st week till the end of follow up.
Conclusion: bilateral segmental internal sphincterotomy is a novel, safe, and
effective way of treating chronic anal fissure, and it is not associated with any risk
of anal incontinence.