Zinc oxide, lidocaine, hot water, and lateral internal sphincterotomy for fissure-in-ano: Randomized controlled study

Abstract

Aim: Aim of this study is to compare the effect of zinc oxide pomade, lidocaine pomade, hot water sitting bath and lateral internal sphincterotomy for treatment of chronic anal fissure in terms of healing and complications. Material and Methods: One hundred and forty five patients who were diagnosed with chronic anal fissure between May 2011 and September 2012 at our clinic were enrolled for this prospective randomized trial. All cases were randomized into four groups. Group 1: The patients would apply 15% of zinc oxide pomade twice a day after the 10 minutes of hot water sitting bath. Group 2: The patients would apply 5% of lidocaine pomade twice a day after the 10 minutes of hot water sitting bath. Group 3: The patients would make only 10 minutes of hot water sitting bath twice a day.Group 4: Lateral internal sphincterotomy was performed to the patients. Healing rates, recurrences,changes in symptoms after the treatment and complications were recorded. Results: There were not any difference within the groups in terms of age and gender. The healing in the Sphincterotomy group significantly much more when compared to the other groups at both the third and the sixth weeks(p<0,001).The other groups were similar with the each other(p>0,05). Conclusion: LIS is superior to zinc oxide, lidocaine or hot water applications. There was no difference between the non-operative treatments