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Abstract

Objective: To compare the efficacy of lateral internal sphincterotomy (LIS) and topical 0.2% glyceryl trinitrate (GTN) ointment in the treatment of chronic anal fissures.
Methodology: This trial was conducted at the Department of Surgery, Mercy Teaching Hospital, Peshawar Medical College, Peshawar. One hundred patients with chronic anal fissure were randomly allocated to two groups. Group A patients were treated with LIS and Group B with GTN. Pain during defecation was assessed using the Visual Analog Scale (VAS) at 2 and 6 weeks of follow-up between both groups.
Results: At the 2-week follow-up we found that 90% patients in the LIS group showed notable efficacy in pain relief when compared to 44% in the GTN group (p=0.0001). At six weeks the efficacy in LIS group was 98% while 58% in the GTN group (p=0.0001).
Conclusion: Lateral internal sphincterotomy (LIS) is notably more effective than topical 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissures.