Short Term Comparison of Incontinence Rate of Open Vs Closed Internal Sphincterotomy
Objectives: To compare incidence of incontinence in patients with chronic anal fissure undergoing lateral sphincterotomy through open and closed method.
Methodology: A total number of 154 patients with chronic anal fissure were included in the study after meeting the criteria. Patients were divided into Group A (closed lateral sphincerotomy with von-graefe knife) and Group B (open lateral sphincterotomy or Parks procedure) through simple random sampling. Post
operatively incontinence was assessed at day 7, at one month follow up, 3 months and then 6 months follow up using the Wexner score.
Results: Out of 154 patients enrolled in the study, only 138 patients were available for analysis and interpretation. Patients in group B had more incidence of incontinence on day 7 when compared to group A (P=0.052). At 1 month follow up this difference of incontinence reduced even further and later there was no
significant difference noted at 3 months and 6 months follow up.
Conclusion: There is no significant difference in rate of incontinence between open and closed lateral internal sphincterotomy. Surgeons should choose to perform the type of surgical procedure on the basis of one's expertise, and other pros and cons of individual techniques rather than continence safety only.
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