Background: In recent years treatment of chronic anal fissure has shifted from surgical to medical. This study compared the ability of two non-surgical treatments - botulinum toxin injections and nitroglycerin ointment - to induce healing in patients with idiopathic anal fissure. Methods: One hundred adults were assigned randomly to receive treatment with either type A botulinum toxin (30 units Botox® or 90 units Dysport®) injected into the internal anal sphincter or 0.2 per cent nitroglycerin ointment applied three times daily for 8 weeks. Results: After 2 months, the fissures were healed in 46 (92 per cent) of 50 patients in the botulinum toxin group and in 35 (70 per cent) of 50 in the nitroglycerin group (P = 0.009). Three patients in the botulinum toxin group and 17 in the nitroglycerin group reported adverse effects (P < 0.001). Those treated with botulinum toxin had mild incontinence to flatus that lasted 3 weeks after treatment but disappeared spontaneously, whereas nitroglycerin treatment was associated with transient, moderate-to-severe headaches. Nineteen patients who did not have a response to the assigned treatment crossed over to the other therapy. Conclusion: Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective option. Copyright © 2007 British Journal of Surgery Society Ltd Published by John Wiley & Sons Ltd.

Brisinda, G., Cadeddu, F., Brandara, F., Marniga, G., Maria, G., Randomized clinical trial comparing botulinum toxin injections with 0.2 per cent nitroglycerin ointment for chronic anal fissure, <<BRITISH JOURNAL OF SURGERY>>, 2007; 94 (2): 162-167. [doi:10.1002/bjs.5514] [http://hdl.handle.net/10807/207651]

Randomized clinical trial comparing botulinum toxin injections with 0.2 per cent nitroglycerin ointment for chronic anal fissure

Brisinda, G.
;
Cadeddu, F.;
2007

Abstract

Background: In recent years treatment of chronic anal fissure has shifted from surgical to medical. This study compared the ability of two non-surgical treatments - botulinum toxin injections and nitroglycerin ointment - to induce healing in patients with idiopathic anal fissure. Methods: One hundred adults were assigned randomly to receive treatment with either type A botulinum toxin (30 units Botox® or 90 units Dysport®) injected into the internal anal sphincter or 0.2 per cent nitroglycerin ointment applied three times daily for 8 weeks. Results: After 2 months, the fissures were healed in 46 (92 per cent) of 50 patients in the botulinum toxin group and in 35 (70 per cent) of 50 in the nitroglycerin group (P = 0.009). Three patients in the botulinum toxin group and 17 in the nitroglycerin group reported adverse effects (P < 0.001). Those treated with botulinum toxin had mild incontinence to flatus that lasted 3 weeks after treatment but disappeared spontaneously, whereas nitroglycerin treatment was associated with transient, moderate-to-severe headaches. Nineteen patients who did not have a response to the assigned treatment crossed over to the other therapy. Conclusion: Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective option. Copyright © 2007 British Journal of Surgery Society Ltd Published by John Wiley & Sons Ltd.
Inglese
Brisinda, G., Cadeddu, F., Brandara, F., Marniga, G., Maria, G., Randomized clinical trial comparing botulinum toxin injections with 0.2 per cent nitroglycerin ointment for chronic anal fissure, <<BRITISH JOURNAL OF SURGERY>>, 2007; 94 (2): 162-167. [doi:10.1002/bjs.5514] [http://hdl.handle.net/10807/207651]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/207651
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