Glyceryl trinitrate vs. lateral sphincterotomy for chronic anal fissure

2001 ◽  
Vol 44 (1) ◽  
pp. 93-97 ◽  
Author(s):  
Justin Evans ◽  
Andrew Luck ◽  
Peter Hewett
2021 ◽  
Vol 15 (10) ◽  
pp. 2600-2601
Author(s):  
Imran Sadiq ◽  
Muhammad Javed Shakir ◽  
Ruqqia Naheed Khan ◽  
Muhammad Akhlaq Ahmed ◽  
Syeda Samina Ashfaq ◽  
...  

Background: Anal fissure is a linear painful mucosal tearing in the distal part of anal canal. It extends from dentate to anal edge. Aim: To compare the glyceryltrinitrate ointment and internal lateral sphincterotomy for anal fissure pain relief in acute/chronic pts. Study Design: Prospective study Place and duration of study: Department of Surgery Unit-II, Fatima Memorial Hospital, Shadman Lahore from 1st October 2018 to 31stDecember 2020. Methodology: 40 pts with acute and chronic anal fissure were enrolled. Half of the patients undergo internal lateral sphincterotomy while other opted 0.2% use of glyceryl trinitrate ointment. Each patient was followed for pain, recovery, complications and recurrence until 12 months for internal lateral sphincterotomy and 18 months in glyceryl trinitrate ointment. Results: There were 24 males and 16 females with a mean age of patients as 30±3.2 years. Initial follow-up of patients showed 100% pain and fissure improvement in internal lateral sphincterotomy group as compared to 60% in glyceryl trinitrate ointment group respectively. Conclusion: Internal lateral sphincterotomy is most efficient and reliable procedure in relieving anal fissure pains. Keywords: Anal fissure, Internal lateral sphincterotomy, Glyceryl trinitrate


2020 ◽  
Vol 8 (3) ◽  
pp. 156-161
Author(s):  
Bikash Bahadur Rayamajhi ◽  
Anjan Khadka ◽  
Kabir Thakali ◽  
Bikash Bikram Thapa ◽  
Narayan Thapa ◽  
...  

Background: The longitudinal tear or defect in the epithelial lining of the anal canal distal to the dentate line is called anal fissure. It is of two types: acute and chronic. The break in the cycle of pain, spasm and ischemia is essential for successful treatment of anal fissure. Among multiple non-surgical treatment approaches, the appropriate approach with good patient compliance might be the use of topical agents as chemical sphincterotomy. However, the effectiveness of these agents has not been evaluated widely. Objectives: To evaluate clinical effectiveness of topical 0.2% glyceryl trinitrate, topical 2% diltiazem and their combination in the treatment of chronic anal fissure. Methodology: The study was prospective comparative type including total 158 patients. Initially, they were given first line therapy followed by chemical sphincterotomy agents. The study drugs were given to 84 patients (three groups - 0.2% glyceryl trinitrate, 2% diltiazem and their combination) who were not healed after initial therapy. Patients were assessed for pain using visual analogue scale and other symptoms prior to and after two and six weeks of therapy. Results: Complete healing rate was higher with combination (92.86%) than individual agents. The reduction of visual analog scale score within each group and between the groups in the period between before and after treatment was found to be statistically significant. Headache and hypotension were the common side effects seen during study. Conclusion: Anal fissures can be successfully managed by chemical sphincterotomy. The topical nitrates and calcium channel blockers in combination are found to be effective choice rather than individual agents.


The Lancet ◽  
1997 ◽  
Vol 349 (9051) ◽  
pp. 573
Author(s):  
Jonathan N Lund ◽  
John H Scholefield

2012 ◽  
Vol 55 (8) ◽  
pp. 893-899 ◽  
Author(s):  
Juan Pérez-Legaz ◽  
Antonio Arroyo ◽  
Pedro Moya ◽  
Jaime Ruiz-Tovar ◽  
Andres Frangi ◽  
...  

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