KMID : 0356720140300030132
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Journal of the Korean Society of Coloproctology 2014 Volume.30 No. 3 p.132 ~ p.134
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Sphincter-Preserving Therapy for Treating a Chronic Anal Fissure: Long-term Outcomes
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Farouk Ridzuan
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Abstract
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Purpose: To estimate the risk of recurrent fissure in ano after sphincter preserving treatments.
Methods: A retrospective case note review, combined with a telephone survey was conducted for all patients treated for a chronic anal fissure between 1998 and 2008.
Results: Six hundred and twelve patients (303 women: mean age, 39 years; range, 16-86 years) were treated for chronic anal fissure between 1998 and 2008. Topical diltiazem 2% was initially prescribed for 8 weeks. The fissure did not heal in 141 patients. These patients (61 women: mean age, 30 years; range, 15-86 years) were treated with 100 IU botulinum A toxin (Botox) injection combined with a fissurectomy under general anaesthesia. Thirty eight patients suffered a recurrence of their fissure within two years. Thirty-four healed with further medical or sphincter conserving surgical therapy while four required a lateral internal sphincterotomy.
Conclusion: The vast majority of patients with chronic anal fissure can be treated with sphincter conserving treatments. This may require several interventions before healing can be achieved. Assessment for recurrence after ¡¯conservative¡¯ treatments requires a minimum of two-year follow-up.
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KEYWORD
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Fissure in ano
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