Abstract | PURPOSE: Although there is enthusiasm for nonoperative management of anal fissures, most trials have been of short duration (6-8 weeks) and long-term outcome is unknown. The purpose of this study was to assess long-term outcome in two cohorts of patients who had participated in a randomized, controlled trial to compare the effectiveness of topical nitroglycerin with internal sphincterotomy in the treatment of chronic anal fissure. METHODS: RESULTS: Overall, 51 of the original 82 patients (62 percent, 27 nitroglycerin, 24 lateral internal sphincterotomy) completed our survey. Mean follow-up was 79 (+/-1) months. Sphincterotomy patients were less likely to have experienced fissure symptoms within the past year (0 vs. 41 percent; P = 0.0004) and were less likely to require subsequent surgical treatment (0 vs. 59 percent; P < 0.0001) than patients treated with nitroglycerin. Patients in the lateral internal sphincterotomy group were more likely to say that they were "very" or "moderately" satisfied with their treatment (100 vs. 56 percent; P = 0.04) and that they would choose the same treatment again (92 vs. 63 percent; P = 0.02) than patients in the nitroglycerin group. Finally, the fecal incontinence and fecal incontinence quality of life scores at six-year follow-up were similar in both groups. CONCLUSIONS:
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Authors | Carl J Brown, Daniel Dubreuil, Laura Santoro, Maria Liu, Brenda I O'Connor, Robin S McLeod |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 50
Issue 4
Pg. 442-8
(Apr 2007)
ISSN: 0012-3706 [Print] United States |
PMID | 17297553
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
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Chemical References |
- Vasodilator Agents
- Nitroglycerin
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Topics |
- Administration, Topical
- Adult
- Anal Canal
(surgery)
- Chronic Disease
- Female
- Fissure in Ano
(drug therapy, surgery)
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Nitroglycerin
(administration & dosage)
- Patient Satisfaction
- Time Factors
- Treatment Outcome
- Vasodilator Agents
(administration & dosage)
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