Comparative study of lateral internal sphincterotomy versus local 0.2% glyceryl trinitrate ointment for the treatment of chronic anal fissure.

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dc.contributor.authorSiddique, Md Ibrahimen_US
dc.contributor.authorMurshed, Khandker Manzooren_US
dc.contributor.authorMajid, M Aen_US
dc.date.accessioned2008-04-12en_US
dc.date.accessioned2009-05-27T03:47:03Z
dc.date.available2008-04-12en_US
dc.date.available2009-05-27T03:47:03Z
dc.date.issued2008-04-12en_US
dc.descriptionBangladesh Medical Research Council Bulletin.en_US
dc.description.abstractThe gold standard surgical treatment of chronic anal fissure is lateral internal sphincterotomy which lowers the resting anal pressure and effectively heals the majority of fissures. Local application of 0.2% glyceryl trinitrate ointment has been used as an agent for chemical sphincterotomy, causing temporary alleviation of sphincter spasm and allowing the fissure to heal without compromising the anal continence. The aim of the present study was to compare the results of surgical sphincterotomy with that of local 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissure. Seventy adult patients between the age of 18 and 50 years with chronic anal fissure were randomized in a prospective trial to receive either surgical sphincterotomy or 0.2% glyceryl trinitrate ointment locally. Patients were followed up at 2 weeks' interval for 10 weeks. Symptom relief, fissure healing and continence scores were the outcomes assessed. Six patients were excluded for protocol violations. Surgical sphincterotomy was significantly more effective in providing pain relief and was associated with significantly better fissure healing rates at 6 weeks and 10 weeks (both p < 0.001). There were substantial problems with compliance in ointment group related to slow healing and longer time needed for symptomatic relief. Minor incontinence was 6% in sphincterotomy group and none in ointment group (p > 0.05). Considering early symptomatic relief, rapid fissure healing and better patient compliance surgical sphincterotomy is the treatment of choice for chronic anal fissure.en_US
dc.description.affiliationDepartment of Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh.en_US
dc.identifier.citationSiddique MI, Murshed KM, Majid MA. Comparative study of lateral internal sphincterotomy versus local 0.2% glyceryl trinitrate ointment for the treatment of chronic anal fissure. Bangladesh Medical Research Council Bulletin. 2008 Apr; 34(1): 12-5en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/254
dc.language.isoengen_US
dc.source.urihttps://www.banglajol.info/index.php/BMRCB/indexen_US
dc.source.urihttps://www.banglajol.info/index.php/BMRCB/article/view/1163/1177en_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshChronic Diseaseen_US
dc.subject.meshDigestive System Surgical Proceduresen_US
dc.subject.meshFemaleen_US
dc.subject.meshFissure in Ano --drug therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNitroglycerin --administration & dosageen_US
dc.subject.meshOintmentsen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVasodilator Agents --administration & dosageen_US
dc.titleComparative study of lateral internal sphincterotomy versus local 0.2% glyceryl trinitrate ointment for the treatment of chronic anal fissure.en_US
dc.typeClinical Trialen_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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