Comparative Study Between Lateral Internal Sphincterotomy vs. Botulinum Toxin Injection In The Treatment Of Chronic Anal Fissure

Background: Anal fissure is one of the most public proctologic illnesses. Breaking the vicious cycle of spasm, ischemia, and pain in CAF is accomplished with surgical or medical procedures. Surgical procedures, such as anal dilatation, posterior midline sphincterotomy, and lateral internal sphincterotomy (LIS), have been the gold standard treatment for anal fissure. botulinum toxin injection seems to be an optimal non-operative therapy with similar healing rates but lowest rate of recurrence. Patients and methods: This is a prospective observational trial was carried out at Department of general Surgery, Faculty of Medicine, Al-Azhar University hospitals. This study was conducted on 50 individuals with chronic anal fissure divided into 2 groups: Group (A): 25 patients was treated with lateral internal sphincterotomy, Group (B): 25 individuals will be treated with botulinum toxin injection, Results: there were significant Correlation amongst Time of healing of fissures & Duration of symptoms and between Time of healing of fissures & Duration of symptoms. There was statistically insignificant variance among the groups regarding Maximal Squeeze Pressure (mmHg) and among the groups After 6 weeks. There was statistically insignificant change among the groups regarding age or sex. Conclusion: In individuals with simple chronic anal fissure, injection of botulinum toxin had approximately the same outcomes as lateral internal sphincterotomy in terms of postoperative pain recovery, bleeding, fissure healing, incontinence & fissure relapse.