BACKGROUND Incontinence to flatus and faecal soiling are distressing complications of sphincterotomy that may occur in up to 35% of patients. Surgical techniques that preserve the anal sphincter, such as manual anal dilatation with fissurectomy may reduce the possibility of postoperative faecal incontinence.This work was carried out to study the efficacy of manual anal dilatation with fissurectomy against lateral internal sphincterotomy in the treatment of chronic fissure-in-ano. METHODS Based on random selection,120 patients underwent either manual dilatation of the anus with fissurectomy or lateral sphincterotomy. Complications related to the procedures were recorded.The first visit was scheduled within one week, followed by a second visit in the subsequent week. Further follow-up was scheduled at the end of six weeks, followed by monthly visits. During each visit, enquiries were made regarding the expected complications. Patients were also examined to rule out anorectal sepsis. The results of the follow-up were tabulated and analyzed. RESULTS There were no reports of incontinence, flatus, or motion among the two groups. There were no observationsof infection (abscess or fistula) among the two groups. There were no reports of anal stenosis among the two groups. 30 patients out of the 120 developed urinary retention. Of them, 18 belonged to the sphincterotomy group and 12 belonged to the fissurectomy group.There were no reports of recurrences among the two categories. CONCLUSION Manual anal dilatation with fissurectomy might be considered as an alternative procedure in the surgical management of chronic anal fissures, given the lower rate of complications but the higher chances of pain.However,its long-term results and efficacy need to be ascertained through more extensive and larger clinical trials.

Manual Dilatation, Fissurectomy, Lateral Sphincterotomy, Chronic Fissure-in-Ano.