{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:59:10Z","timestamp":1790269150347,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic fissure-in-ano is a common anorectal condition characterized by severe pain and impaired quality of life, primarily due to sustained internal anal sphincter hypertonia and reduced anodermal blood flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aimed to compare the clinical outcomes of lateral internal anal sphincterotomy and botulinum toxin injection in the management of chronic fissure-in-ano.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This study was conducted in a tertiary care hospital and included 210 patients with chronic fissure in ano. Patients were randomized into two groups: Group A (lateral internal anal sphincterotomy,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 105) and Group B (botulinum toxin injection,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 105). Baseline demographic and clinical parameters were comparable between the groups. Statistical analysis was performed using appropriate comparative tests, with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Intraoperative blood loss and immediate postoperative pain were significantly higher in the lateral internal anal sphincterotomy group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). However, pain scores at 1 month and 6 months were significantly lower in the sphincterotomy group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Lateral internal anal sphincterotomy provides superior medium- and long-term outcomes in terms of pain relief, healing, effectiveness, and recurrence compared to botulinum toxin injection, with an acceptable and largely transient impact on continence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_572_26","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:00:22Z","timestamp":1790265622000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Evaluation of Lateral Internal Anal Sphincterotomy and Botulinum Toxin Injection in the Management of Chronic Fissure in Ano"],"prefix":"10.4103","author":[{"given":"Mahalakshmi","family":"Nagarajan","sequence":"first","affiliation":[{"name":"Department of General Surgery, SRM Medical College Hospital and Research Center, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sivamarieswaran","sequence":"additional","affiliation":[{"name":"Department of General Surgery, SRM Medical College Hospital and Research Center, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth","family":"Thiyagarajan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, SRM Medical College Hospital and Research Center, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Reji","sequence":"additional","affiliation":[{"name":"Department of General Surgery, SRM Medical College Hospital and Research Center, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,24]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_572_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:00:23Z","timestamp":1790265623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_572_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_572_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"2026-05-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}