Randomized clinical trial comparing oral nifedipine with lateral anal sphincterotomy and tailored sphincterotomy in the treatment of chronic anal fissure

Authors: Ho K.-S.; Ho Y.-H.

Source: British Journal of Surgery, Volume 92, Number 4, April 2005 , pp. 403-408(6)

Buy & download fulltext article:

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.

Abstract:

Background:

The conventional treatment of chronic anal fissure is lateral sphincterotomy (LAS). The alternative options of tailored sphincterotomy (TS) and ‘chemical sphincterotomy’ using medication such as nifedipine have recently become available.

Methods:

A prospective randomized trial was conducted to compare LAS with TS and oral nifedipine. The main endpoints were fissure healing, symptom relief, recurrence and continence.

Results:

One hundred and thirty-two patients were treated and followed up for 4 months. LAS was significantly more effective than TS in providing pain relief (P = 0·004) and better patient satisfaction (P = 0·020) at 4 weeks. Surgery (LAS and TS) was associated with significantly better fissure healing rates (both P < 0·001 at 16 weeks) and less recurrence (both P = 0·003) than nifedipine. There were substantial problems with compliance in the nifedipine group (17 of 41 patients), related to side-effects and slow healing. There were no differences in continence between the three treatment groups.

Conclusion:

LAS was most effective in providing pain relief and allowing rapid fissure healing, with minimal recurrence and no increased risk of incontinence, in patients with good anal sphincter function. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Research article

DOI: http://dx.doi.org/10.1002/bjs.4882

Affiliations: 1: Department of Colorectal Surgery, Singapore General Hospital, Singapore

Publication date: 2005-04-01

More about this publication?

As of January 2010, this journal will no longer be available on IngentaConnect, please visit Wiley InterScience to arrange continued access to this content
Access this journal at Wiley InterScience
ingentaconnect is not responsible for the content or availability of external websites

Randomized clinical trial comparing oral nifedipine with lateral anal sphincterotomy and tailored sphincterotomy in the treatment of chronic anal fissure

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages