Prasanth, M M (2016) Comparision between Topical Glyceryl Trinitrate and Lateral Anal Sphincterotomy in Treatment of Chronic Fissure in Ano. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
AIM : The objective of my study is to compare the efficacy of topical GTN over lateral sphincterotomy in the management of chronic fissure in ano. METHODOLOGY : This study is based on analysis of 104 patients with fissure in ano who underwent treatment in Govt Thanjavur Medical College Hospital,Thanjavur from August 2014-2015. patients were divided in to 52 each who were treated by medical and surgical methods respectively on a prospective basis. RESULTS : In this study, males were commonly affected than females.. The most common age group were 41-50yrs. Fissure in ano is rare in children and old age. Majority of the patients presented with pain during defecation. Constipation was the major predisposing factor among all cases. Most of the fissures were located in the posterior midline. Most of the patients with fissures of long duration had sentinel skin tag and hypertrophied papilla. Anterior fissures were slightly more common in females. No patients studied had inflammatory bowel disease. Patients who were treated surgically by open partial lateral anal sphincterotomy had better relief of symptoms. Around 27% patients managed medically by 0.2% GTN did not have relief of symptoms after one month of treatment, who either discontinued treatment or required conversion to surgery. Complication of Glyceryl trinitrate(GTN) is headache which occurred in majority of patients. Patients treated surgically had few complications in the preoperative period which subsided after two weeks. Pain is the most common post operative complication of lateral anal sphincterotomy. It is experience around 11 percentage of the patients undergoing surgery. CONCLUSION : Most acute analfissures heal with conservative measures. Those that become chronic may respond to conservative management glyceryl trinitrate 0.2% topical cream application. Persisting fissures and symptomatic patients should be considered for lateral partial internal sphincterotomy. So, in chronic anal fissure 0.2% glyceryl trinitrate application can be considered as an initial line of management.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Topical Glyceryl Trinitrate ; Lateral Anal Sphincterotomy ; Treatment ; Chronic Fissure ; Ano. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 20 Dec 2017 13:39 |
| Last Modified: | 20 Dec 2017 13:39 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4596 |
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