Background: Chronic fissure in ano is a distal anal mucosal tear that require surgical correction. Lateral internal sphincterectomy is considered as gold standard technique with high recovery rate and have transient incontinence and recurrence drawbacks. The present study was designed to assess the efficacy of tailored lateral sphincterectomy and conventional lateral sphincterectomy in the management of chronic anal fissures. Material and Methods: Fifty-two clinically diagnosed cases of chronic fissure in ano above 21 years of age were recruited. Cases were randomly divided into two groups. Group 1 treated with tailored sphincterectomy and group 2 with conventional lateral internal sphincterectomy. Cases were followed for two weeks and assessed the bleeding per-rectum, pain score, fecal incontinence, and flatus incontinence. Results: The mean pain score in tailored group was 5.3 on 1st day, 3.0 on 3rd day and 1.3 on 5th day, whereas in group 2, pain scores were 5.4, 3.1, 1.5 on 1st, 3rd, and 5th day respectively. Fecal incontinence (5 in conventional & none in tailored), flatus incontinence (1 in conventional & none in tailored), fecal soiling (1 in tailored & 2 in conventional), and recurrence (1 in tailored and 5 in conventional) was observed and the difference of fecal incontinence (p<0.001), flatus incontinence (p=0.0204) and recurrence (p=0.0368) was statistically significant. Conclusion: Tailored lateral sphincterectomy is an effective treatment choice for the chronic fissure in ano than conventional lateral sphincterectomy in terms of low fecal and flatus incontinence and recurrence rate.

Background: Chronic fissure in ano is a distal anal mucosal tear that require surgical correction. Lateral internal sphincterectomy is considered as gold standard technique with high recovery rate and have transient incontinence and recurrence drawbacks. The present study was designed to assess the efficacy of tailored lateral sphincterectomy and conventional lateral sphincterectomy in the management of chronic anal fissures. Material and Methods: Fifty-two clinically diagnosed cases of chronic fissure in ano above 21 years of age were recruited. Cases were randomly divided into two groups. Group 1 treated with tailored sphincterectomy and group 2 with conventional lateral internal sphincterectomy. Cases were followed for two weeks and assessed the bleeding per-rectum, pain score, fecal incontinence, and flatus incontinence. Results: The mean pain score in tailored group was 5.3 on 1st day, 3.0 on 3rd day and 1.3 on 5th day, whereas in group 2, pain scores were 5.4, 3.1, 1.5 on 1st, 3rd, and 5th day respectively. Fecal incontinence (5 in conventional & none in tailored), flatus incontinence (1 in conventional & none in tailored), fecal soiling (1 in tailored & 2 in conventional), and recurrence (1 in tailored and 5 in conventional) was observed and the difference of fecal incontinence (p<0.001), flatus incontinence (p=0.0204) and recurrence (p=0.0368) was statistically significant. Conclusion: Tailored lateral sphincterectomy is an effective treatment choice for the chronic fissure in ano than conventional lateral sphincterectomy in terms of low fecal and flatus incontinence and recurrence rate.