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Annals of African medicine · 2026

Comparative Evaluation of Lateral Internal Anal Sphincterotomy and Botulinum Toxin Injection in the Management of Chronic Fissure in Ano.

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Nagarajan Mahalakshmi, Sivamarieswaran R, Thiyagarajan Srikanth, Reji Abhishek

Аннотация

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, n = 105) and Group B (botulinum toxin injection, n = 105). Baseline demographic and clinical parameters were comparable between the groups. Statistical analysis was performed using appropriate comparative tests, with P < 0.05 considered statistically significant.

RESULTS: Intraoperative blood loss and immediate postoperative pain were significantly higher in the lateral internal anal sphincterotomy group (P < 0.0001). However, pain scores at 1 month and 6 months were significantly lower in the sphincterotomy group (P = 0.01 and P = 0.001, respectively).

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.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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