Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Introduction: Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF). However, LAS is often done under spinal or general anaesthesia incurring huge treatment costs and hospital stay. Aim: To study if LAS can be treated with Local Anaesthesia (LA) thereby, reducing the costs and the anaesthetic risk to patients with no significant change in the surgical ease or clinical outcome. Materials and Methods: A total of 79 patients with chronic fissure underwent randomized allocation to two treatment arms – The first to undergo LAS under LA and the second under Spinal Anaesthesia (SA). The primary outcome variables studied were complications like post-operative pain, infections, healing rate of fissure and incontinence rates. Secondary outcome variables studied were cost, hospital stay and need for additional anaesthetic. Results: A total of 79 patients underwent LAS procedure. A total of 42 patients had LA and 39 patients had SA. There was no statistically significant difference in the healing rate, pain, infection and incontinence rates between the two groups. Moreover, the LA group incurred lower cost, reduced hospital stay and reduced risk of anaesthesia. Conclusions: LAS can be satisfactorily performed under local anaesthesia with no increased risk of pain or complications, and is best suited for resource-poor surgical settings.
Authors and Affiliations
Ravikumar Manoharan, Tarun Jacob, Santosh Benjamin, Sumonth Kirishnan
Keywords
Related Articles
- EP ID EP328389
- DOI 10.7860/JCDR/2017/21779.9299
- Views 147
- Downloads 0
Cisplatin Induced SIADH in Patients Receiving Concurrent Chemoradiation Therapy: A Rare Clinical Observation
ABSTRACT The Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) can be attributed to various causes such as CNS disorders like head trauma, stroke, pulmonary lesions like TB, bacterial pneumonia, as paraneo...
The Short Cervix Management as a Prevention Method of Preterm Birth
ABSTRACT Introduction: Preterm birth is considered to be the most common cause of antenatal mortality and further newborns’ morbidity in the world. The majority of children, who are born before physiologically normal ter...
Metabolic Syndrome and Cardiovascular Disease Risk in patients with Depressive disorder on Antidepressive Medication
ABSTRACT Introduction: Depression and Metabolic syndrome both are the two major public health issues. The depressive patients are at higher risk for Cardiovascular Disease (CVD). The use of antidepressant medication has...
Dasatinib Induced Cardiac TamponadeA Rare Association
Drug induced cardiac tamponade is rare. Therapy for imatinib resistant Chronic Myeloid Leukaemia (CML) is an emerging challenge in clinical haematology. For such cases treatment with second line tyrosine kinase inhibitor...
Nutritional Intake in Low Body Mass Index (BMI) Males with Type 1 Diabetes and Fibrocalcific Pancreatic Diabetes: What are the Unmet Needs? A Cross-Sectional Study from a South Indian Tertiary Care Hospital
Introduction: There is paucity of data on the nutritional intake in low Body Mass Index (BMI) Asian Indians with diabetes. Aim: To study the difference in the nutrient intake pattern in low-BMI Type 1 Diabetes Mellitus (...