Internal sphincterotomy is superior to topical nitroglycerin in the treatment of chronic anal fissure

Richard, Carole; Grégoire, R.; Plewes, E. A.; Silverman, Ralph; Burul, C.; Buie, Donald; Reznick, Richard K.; Ross, Theodore M.; Burnstein, Marcus J.; O’Connor, Brenda I.; Mukraj, Davin; McLeod, Robin S.

doi:10.1007/bf02236548

Cited by 169 publications

(33 citation statements)

References 21 publications

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“…Major complications requiring reoperation (bleeding, fistula, abscess or unhealed wound), and minor complications such as pruritis, persistent wound pain, bleeding, abscess, discharge, urgency, impaction, or defect of continence were seen in literature. 18 CONCLUSION: Chronic anal fissure is an evidently common condition which influences the quality of life of the patients to a certain extent. Considering today's busy world, it is, but, natural for the patients to opt for non-invasive ways of treatment which yield results that are comparable to their surgical counterparts.…”

Section: Resultsmentioning

confidence: 99%

Comparison Between Lateral Internal Anal Sphincterotomy and Diltiazem in the Treatment of Chronic Anal Fissure

Razack¹,

Raj²

2015

jemds

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Section: Resultsmentioning

confidence: 99%

Comparison Between Lateral Internal Anal Sphincterotomy and Diltiazem in the Treatment of Chronic Anal Fissure

Razack¹,

Raj²

2015

jemds

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“…[31][32][33][34] Recurrence rates after sphincterotomy are exceedingly low when properly performed by a surgeon. We are utilizing the fissurectomy wound to enhance healing acceleration.…”

Section: Discussionmentioning

confidence: 99%

Anal fissures: Open lateral internal sphincterotomy results

Salih

2015

JER

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Background: Lateral Internal Sphincterotomy is the procedure of choice for chronic anal fissure because it relieves symptoms and heals the fissure in nearly all patients. However, data on its postoperative complications are limited particularly fecal incontinence. Therefore, the aim of this study is to investigate the results of this procedure in terms of recurrence rate, complications and patient satisfaction. Methods: The medical records of 80 patients from 4 centers were collected during 20 months and evaluated retrospectively. Results: Incontinence was observed in 2 (2.5%) patients. The patients were discharged at the same day of the operation. During the average follow-up of 24 months, two patients (2.5%) developed recurrent disease. In addition, patients' satisfaction was high (95%). Conclusions: Lateral internal sphincterotomy is the procedure of choice for chronic anal fissure because it relieves symptoms and heals the fissure in nearly all patients with very low rate of complications, negligible recurrence and good patient satisfaction.

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“…Treatment of the CAF depends on reducing the resting anal pressure. Internal sphincterotomy is successful in about 95% of patients [2, 4], but long-term impairment of continence has been reported [1, 2]. Therefore, there has been an interest in chemical sphincterotomy because this does not affect sphincter function permanently.…”

Section: Discussionmentioning

confidence: 99%

“…Glyceryl trinitrate (GTN) has an efficacy of 68% in the management of CAF, but headaches are a major side effect [3]. Approximately 20% of patients treated with GTN are unable to tolerate the side effects and cease treatment [4, 5, 6]. Therefore the compliance of patients to the therapy applied is also important.…”

Section: Introductionmentioning

confidence: 99%

Oral Nifedipine in the Treatment of Chronic Anal Fissure

Ağaoğlu¹,

Cengiz²,

Arslan³

et al. 2003

Dig Surg

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Background: The purpose of this study was to demonstrate the effect of oral nifedipine on maximal resting anal pressure (MRAP) in healthy volunteers and to evaluate its role in the treatment of chronic anal fissure (CAF). Methods: MRAP was measured in 10 healthy volunteers and 10 patients with CAF before and after oral nifedipine (20 mg b.i.d.). Patients were assessed on the first visit and every fortnight for measurement of MRAP, pain scores, blood pressure, pulse rate, healing of the fissure and adverse effects. Treatments were continued until healing had occurred or for up to 8 weeks. Results: MRAP values before and after nifedipine were 73.2 and 49.3 cm H₂O, respectively, in healthy volunteers (p < 0.001). Nifedipine caused a reduction in mean MRAP from 105.2 to 74.0 cm H₂O (p < 0.001) in patients with CAF. Pain scores were significantly reduced after 2 weeks of treatment with nifedipine (p < 0.001) and continued throughout the treatment period. At the end of the study 6 of the 10 patients treated with nifedipine were deemed to be healed (n = 5) or improved (n = 1). Headache occurred in 1 patient. Conclusion: We conclude that oral nifedipine is effective in reducing MRAP and should become the first-line treatment for CAF.

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Internal sphincterotomy is superior to topical nitroglycerin in the treatment of chronic anal fissure

Abstract: Internal sphincterotomy is superior to topical nitroglycerin 0.25 percent in the treatment of chronic anal fissure, with a high rate of healing, few side effects, and low risk of early incontinence. Thus, internal sphincterotomy remains the treatment of choice for chronic anal fissure.

Cited by 169 publications

References 21 publications

Comparison Between Lateral Internal Anal Sphincterotomy and Diltiazem in the Treatment of Chronic Anal Fissure

Comparison Between Lateral Internal Anal Sphincterotomy and Diltiazem in the Treatment of Chronic Anal Fissure

Anal fissures: Open lateral internal sphincterotomy results

Oral Nifedipine in the Treatment of Chronic Anal Fissure

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