Surgical versus chemical (botulinum toxin) sphincterotomy for chronic anal fissure: Long-term results of a prospective randomized clinical and manometric study

Arroyo, Antonio; Perez, Francisco A.; Serrano, Pilar; Candela, Fernando; Lacueva, Javier; Calpena, Rafael

doi:10.1016/j.amjsurg.2004.06.045

Cited by 128 publications

(77 citation statements)

References 25 publications

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“…Fissure recurrence was 55% within one year compared with 8% with lateral internal sphincterotomy. [20] One single-center, retrospective study found that the use of botulinum toxin injection helped prevent surgery in 73% of patients who presented with anal fissure in 2004 compared with patients in 1993 when sphincterotomy was first-line therapy. [21] Thus, botulinum toxin injection offers reasonable success with minimal side effects and is a reasonable option for "chemical sphincterotomy" in the management of chronic anal fissure.…”

Section: Methodsmentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

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Anal fissure is one of the most common anorectal problems. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. There are many options to treat chronic fissures in ano. Some of them are non-surgical while the others are surgical. The efficacy claimed by each of the prevalent method is very high but the inconsistencies and contraindications are equally strong. To date, lateral sphincterotomy has been favoured by most of the proctologists, because it is the least extensive surgical procedure and is offering a long lasting relief in sphincter spasm. Various management technique are reviewed in this article along with Advancement flap for anterior fissure and a new method combining the age-old technique of Lord's manual dilatation followed by radio surgery is also highlighted along with their complications. The addition of radio surgery is found useful for refreshing the edges of the fissure and to tackle pathologies namely sentinel pile, small internal piles or hypertrophied anal papillae often found associated with chronic fissures. Revisiting the trends of treatment of chronic anal fissures, the most preferred options are the manual dilatation with radio surgery and the subcutaneous lateral anal sphincterotomy. Both methods are easy to perform, have negligible complications and no special setup is needed, except the radio surgical unit, in case of the first procedure.

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Section: Methodsmentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

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“…A los 2 meses el grupo Bottox presento 85% de curacion en comparacion al 97.5% en el grupo de Esfinterotomia; a los 12 meses fue 75% para el grupo Bottox y 97.5% para el grupo esfinterotomia. Los casos de incontinencia a los 2 meses fue del 7.5% para el grupo de esfinterotomia y 5% para el grupo Bottox 6 , a los 12 meses los resultados fueron 5% y 0% respectivamente.…”

Section: Resultsunclassified

Bottox O Esfinterotomia Para El Tratamiento De La Fisura Anal Crónica

Flores¹

2017

RFMH

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RESUMENObjetivos: Determinar cuál es el mejor tratamiento para fisura anal crónica en base a la evidencia existente. Diseño: Revisión bibliográfica con palabras clave "Fisura Anal Crónica", "Bottox" y "Esfinterotomia". Métodos: Se consultaron las bases de datos Medline, Pubmed, Cochrane, EMBASE. Se incluyeron revisiones sistemáticas, estudios prospectivos randomizados controlados y guías de manejo, del año 2000 al 2017. El porcentaje de curación e incontinencia fue evaluado a los 2 meses y 12 meses en el grupo de tratamiento con Bottox y con Esfinterotomia lateral interna. Resultados: Se seleccionaron 3 estudios prospectivos randomizados controlados, 2 revisiones sistemáticas y 1 guía de tratamiento. El porcentaje de curacion a los 12 meses se mantuvo sobre 92% en el grupo con esfinterotomia lateral interna y el máximo en el grupo Bottox fue 75.4%. El porcentaje de incontinencia a los 12 meses es variable en los trabajos revisados, pero disminuye en todos, variando desde 4 -16% en el grupo con esfinterotomia lateral interna y en el grupo Bottox fue 0%. Conclusión: La esfinterotomia lateral interna presenta mejores resultados de curacion a largo plazo y los porcentajes de incontinencia disminuyen a los 12 meses presentando mayor variación.Palabras clave: Fisura Anal Crónica; Bottox; Esfinterotomia. (fuente: DeCS BIREME) ABSTRACTObjectives: Determine what is the best treatment for chronic anal fissure based on existing evidence. Design: Bibliographic review with key words "Chronic Anal Fissure", "Bottox" and "Sphincterotomy". Methods: The databases Medline, Pubmed, Cochrane, EMBASE were consulted. Systematic reviews, controlled randomized prospective studies and management guidelines were included, from 2000 to 2017. The percentage of cure and incontinence was evaluated at 2 months and 12 months in the treatment group with Bottox and with internal lateral sphincterotomy. Results: Three randomized controlled prospective studies, 2 systematic reviews and 1 treatment guideline were selected. The percentage of cure at 12 months remained above 92% in the group with internal lateral sphincterotomy and the maximum in the Bottox group was 75.4%. The percentage of incontinence at 12 months is variable in the reviewed works, but decreases in all, varying from 4 -16% in the group with internal lateral sphincterotomy and in the Bottox group it was 0%. Conclusion: The internal lateral sphincterotomy shows better long-term healing results and the incontinence percentages decrease after 12 months, presenting greater variation.Key words: Chronic Anal Fissure; Bottox; Sphincterotomy. (source: MeSH NLM) ARTÍCULO ORIGINAL DOI 10.25176/RFMH.v17.n3.1191 Journal home page: http://revistas.urp.edu.pe/index.php/RFMH © Los autores. Este artículo es publicado por la Revista de la Facultad de Medicina Humana, Universidad Ricardo Palma. Este es un artículo de Open Access distribuido bajo los términos de la Licencia Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacional.(http://creativecommons.org/licenses/by-nc-sa/4.0/),...

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“…After a follow up period of six months, it was found that the rate of recurrence was significantly higher in botulinum toxin injection Group. [29] Richard et al [14] concluded that surgical sphincterotomy improved healing rate at 6 weeks (89% vs. 29%) and reduced the further requirement for surgery (3% vs. 89%) in his trial of 82 patients [30] .…”

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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Surgical versus chemical (botulinum toxin) sphincterotomy for chronic anal fissure: Long-term results of a prospective randomized clinical and manometric study

Cited by 128 publications

References 25 publications

Anal Fissure Revisited : A Systematic Review

Anal Fissure Revisited : A Systematic Review

Bottox O Esfinterotomia Para El Tratamiento De La Fisura Anal Crónica

Anal fissures: Open lateral internal sphincterotomy results

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