LATERAL INTERNAL SPHINCTEROTOMY VS BOTOX INJECTION FOR TREATMENT OF CHRONIC ANAL FISSURE

Abstract

Objective:

To compare the effectiveness in terms of cure rates for chronic anal fissure treatment.

Methods:

This randomized controlled trial was conducted in the General Surgery Unit of Mayo Hospital, Lahore. We included 60 patients with a diagnosis of chronic anal fissure aged 18 to 70 years from December 2024 to April 2025. In the first group (Group A), the open method was employed for lateral internal sphincterotomy (LIS). In the second group (Group B), patients received an injection of botulinum toxin A. frequency of complete healing was determined at 21^st day of treatment.

Results:

The LIS group had a mean age of 37.57 years (± 12.82), while the Botox group had a mean age of 40.8 years (± 11.32), resulting in a p-value of 0.30. In terms of gender distribution, the LIS group had 21 males (70%) and 9 females (30%), while the Botox group consisted of 18 males (60%) and 12 females (40%), with a p-value of 0.58. The LIS group demonstrated a successful healing rate of 28 (93.3%), significantly higher than the Botox group, which had a success rate of 19 (63.3%), p-value 0.004.

Conclusion:

The rate of complete healing of anal fistula is significantly higher in patients treated with LIS in comparison to patients receiving Botox injection