Randomized clinical trial comparing oral nifedipine with lateral anal sphincterotomy and tailored sphincterotomy in the treatment of chronic anal fissure
Ho, K.-S., and Ho, Y.-H. (2005) Randomized clinical trial comparing oral nifedipine with lateral anal sphincterotomy and tailored sphincterotomy in the treatment of chronic anal fissure. British Journal of Surgery, 92 (4). pp. 403-408.
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View at Publisher Website: http://dx.doi.org/10.1002/bjs.4882
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.
|Item Type:||Article (Refereed Research - C1)|
|Keywords:||bowel disease; incontinence; surgery; treatment, medical|
|FoR Codes:||11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 100%|
|SEO Codes:||92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%|
|Deposited On:||01 Apr 2010 11:38|
|Last Modified:||18 Oct 2013 00:45|
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