Systematic review: The treatment of anal fissure

Alimentary Pharmacology and Therapeutics

Volumn 24, Issue 2, 2006, Pages 247-257

  Steele, S R ^a   Madoff, R D ^b  

^a MADIGAN ARMY MEDICAL CENTER   (United States)

^b UNIVERSITY OF MINNESOTA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANALGESIC AGENT; BETHANECHOL; BOTULINUM TOXIN; BOTULINUM TOXIN A; DILTIAZEM; EMLA; GLYCERYL TRINITRATE; HYDROCORTISONE; ISOSORBIDE DINITRATE; LIDOCAINE; NARCOTIC AGENT; NIFEDIPINE; PLACEBO; SILDENAFIL;

ANAMNESIS; ANUS FISSURE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DIZZINESS; FECES INCONTINENCE; HEADACHE; HEALTH CARE ORGANIZATION; HIGH FIBER DIET; HUMAN; MEDLINE; NAUSEA; PRIORITY JOURNAL; RECTUM HEMORRHAGE; REVIEW; SMELLING DISORDER; SPHINCTEROTOMY; TACHYPHYLAXIS; TASTE DISORDER;

ADMINISTRATION, ORAL; ADMINISTRATION, TOPICAL; BOTULINUM TOXIN TYPE A; BOTULINUM TOXINS, TYPE A; DIET; DILATATION; FISSURE IN ANO; GASTROINTESTINAL AGENTS; HUMANS; INJECTIONS, INTRALESIONAL;

EID: 33745651802     PISSN: 02692813     EISSN: 13652036     Source Type: Journal    
DOI: 10.1111/j.1365-2036.2006.02990.x     Document Type: Review

References (98)

1. Goligher JC. Surgery of the Anus, Rectum and Colon, 5th edn. London: Bailliere Tindall, 1984.
2. Corman ML. Anal fissures. In: Corman ML, ed. Colon & Rectal Surgery, 5th edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2005: 255-77.
3. Lindsey I, Jones OM, Cunningham C, Mortensen NJ. Chronic anal fissure. Br J Surg 2004; 91: 270-9.
4. Notaras MJ. Anal fissure and stenosis. Surg Clin North Am 1988; 68: 1427-40.
5. Brodie BC. Lectures on diseases of the rectum; lecture III; preternatureal contraction of the sphincter ani. Lond Med Gaz 1835; 16: 26-31.
6. Hancock BD. The internal sphincter and anal fissure. Br J Surg 1977; 64: 92-5.
7. Lin JK. Anal manometric studies in hemorrhoids and anal fissures. Dis Colon Rectum 1989; 32: 839-42.
8. Gibbons CP, Read NW. Anal hypertonia in fissures: cause or effect? Br J Surg 1986; 73: 443-5.
9. Hiltunen KM, Matikainen M. Anal manometric evaluation in anal fissure. Effect of anal dilation and lateral subcutaneous sphincterotomy. Acta Chir Scand 1986; 152: 65-8.
10. Keck JO, Staniunas RJ, Coller JA, Barrett RC, Oster ME. Computer-generated profiles of the anal canal in patients with anal fissure. Dis Colon Rectum 1995; 38: 72-9.
11. Lund JN. Nitric oxide deficiency in the internal anal sphincter of patients with chronic anal fissure. Int J Colorectal Dis 2005 (Epub ahead of print).
12. Lund JN, Binch C, McGrath J, Sparrow RA, Scholefield JH. Topographical distribution of blood supply to the anal canal. Br J Surg 1999; 86: 496-8.
13. Klosterhalfen B, Vogel P, Rixen H, Mittermayer C. Topography of the inferior rectal artery: a possible cause of chronic, primary anal fissure. Dis Colon Rectum 1989; 32: 43-52.
14. Gosselink MP, Darby M, Zimmerman DD, Gruss HJ, Schouten WR. Treatment of chronic anal fissure by application of L-arginine gel: a phase II study in 15 patients. Dis Colon Rectum 2005; 48: 832-7.
15. Kua KB, Kocher HM, Kelkar A, Patel AG. Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures. ANZ J Surg 2001; 71: 548-50.
16. Schouten WR, Briel JW, Auwerda JJ, De Graaf EJ. Ischaemic nature of anal fissure. Br J Surg 1996; 83: 63-5.
17. Schouten WR, Briel JW, Auwerda JJ. Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal fissures. Dis Colon Rectum 1994; 37: 664-9.
18. Jensen SL. Treatment of first episodes of acute anal fissure: prospective randomised study of lignocaine ointment versus hydrocortisone ointment or warm sitz baths plus bran. Br Med J (Clin Res Ed) 1986; 292: 1167-9.
19. Jensen SL. Maintenance therapy with unprocessed bran in the prevention of acute anal fissure recurrence. J R Soc Med 1987; 80: 296-8.
20. Hananel N, Gordon PH. Re-examination of clinical manifestations and response to therapy of fissure-in-ano. Dis Colon Rectum 1997; 40: 229-33.
21. Shub HA, Salvati EP, Rubin RJ. Conservative treatment of anal fissure: an unselected, retrospective and continuous study. Dis Colon Rectum 1978; 21: 582-3.
22. Sonmez K, Demirogullari B, Ekingen G, et al. Randomized, placebo-controlled treatment of anal fissure by lidocaine, EMLA, and GTN in children. J Pediatr Surg 2002; 37: 1313-6.
23. Gough MJ, Lewis A. The conservative treatment of fissure-in-ano. Br J Surg 1983; 70: 175-6.
24. Bacher H, Mischinger HJ, Werkgartner G, et al. Local nitroglycerin for treatment of anal fissures: an alternative to lateral sphincterotomy? Dis Colon Rectum 1997; 40: 840-5.
25. Lund JN, Scholefield JH. Glyceryl trinitrate is an effective treatment for anal fissure. Dis Colon Rectum 1997; 40: 468-70.
26. Maria G, Cassetta E, Gui D, Brisinda G, Bentivoglio AR, Albanese A. A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. N Engl J Med 1998; 338: 217-20.
27. Antropoli C, Perrotti P, Rubino M, et al. Nifedipine for local use in conservative treatment of anal fissures: preliminary results of a multicenter study. Dis Colon Rectum 1999; 42: 1011-5.
28. Brisinda G, Maria G, Bentivoglio AR, Cassetta E, Gui D, Albanese A. A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure [see comments] [published erratum appears in N Engl J Med 1999 Aug 19;341(8):624]. N Engl J Med 1999; 341: 65-9.
29. Carapeti EA, Kamm MA, McDonald PJ, Chadwick SJ, Melville D, Phillips RK. Randomised controlled trial shows that glyceryl trinitrate heals anal fissures, higher doses are not more effective, and there is a high recurrence rate. Gut 1999; 44: 727-30.
30. Kennedy ML, Sowter S, Nguyen H, Lubowski DZ. Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo-controlled trial and long-term follow-up. Dis Colon Rectum 1999; 42: 1000-6.
31. Altomare DF, Rinaldi M, Milito G, et al. Glyceryl trinitrate for chronic anal fissure - healing or headache? Results of a multicenter, randomized, placebo-controlled, double-blind trial. Dis Colon Rectum 2000; 43: 174-9.
32. Richard CS, Gregoire R, Plewes EA, et al. Internal sphincterotomy is superior to topical nitroglycerin in the treatment of chronic anal fissure: results of a randomized, controlled trial by the Canadian Colorectal Surgical Trials Group. Dis Colon Rectum 2000; 43: 1048-57; discussion 57-8.
33. Zuberi BF, Rajput MR, Abro H, Shaikh SA. A randomized trial of glyceryl trinitrate ointment and nitroglycerin patch in healing of anal fissures. Int J Colorectal Dis 2000; 15: 243-5.
34. Evans J, Luck A, Hewett P. Glyceryl trinitrate vs. lateral sphincterotomy for chronic anal fissure: prospective, randomized trial. Dis Colon Rectum 2001; 44: 93-7.
35. Jonas M, Neal KR, Abercrombie JF, Scholefield JH. A randomized trial of oral vs. topical diltiazem for chronic anal fissures. Dis Colon Rectum 2001; 44: 1074-8.
36. Werre AJ, Palamba HW, Bilgen EJ, Eggink WF. Isosorbide dinitrate in the treatment of anal fissure: a randomised, prospective, double blind, placebo-controlled trial. Eur J Surg 2001; 167: 382-5.
37. Libertiny G, Knight JS, Farouk R. Randomised trial of topical 0.2% glyceryl trinitrate and lateral internal sphincterotomy for the treatment of patients with chronic anal fissure: long-term follow-up. Eur J Surg 2002; 168: 418-21.
38. Kocher HM, Steward M, Leather AJ, Cullen PT. Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure. Br J Surg 2002; 89: 413-7.
39. Ezri T, Susmallian S. Topical nifedipine vs. topical glyceryl trinitrate for treatment of chronic anal fissure. Dis Colon Rectum 2003; 46: 805-8.
40. Bielecki K, Kolodziejczak M. A prospective randomized trial of diltiazem and glyceryltrinitrate ointment in the treatment of chronic anal fissure. Colorectal Dis 2003; 5: 256-7.
41. Mentes BB, Irkoracu O, Akin M, Leventoglu S, Tatlicioglu E. Comparison of botulinum toxin injection and lateral internal sphincterotomy for the treatment of chronic anal fissure. Dis Colon Rectum 2003; 46: 232-7.
42. Brisinda G, Albanese A, Cadeddu F, et al. Botulinum neurotoxin to treat chronic anal fissure: results of a randomized 'Botox vs. Dysport' controlled trial. Aliment Pharmacol Ther 2004; 19: 695-701.
43. Arroyo A, Perez F, Serrano P, Candela F, Lacueva J, Calpena R. Surgical versus chemical (botulinum toxin) sphincterotomy for chronic anal fissure: long-term results of a prospective randomized clinical and manometric study. Am J Surg 2005; 189: 429-34.
44. Iswariah H, Stephens J, Rieger N, Rodda D, Hewett P. Randomized prospective controlled trial of lateral internal sphincterotomy versus injection of botulinum toxin for the treatment of idiopathic fissure in ano. ANZ J Surg 2005; 75: 553-5.
45. Gorfine SR. Treatment of benign anal disease with topical nitroglycerin. Dis Colon Rectum 1995; 38: 453-6; discussion 6-7.
46. Lund JN, Armitage NC, Scholefield JH. Use of glyceryl trinitrate ointment in the treatment of anal fissure. Br J Surg 1996; 83: 776-7.
47. Watson SJ, Kamm MA, Nicholls RJ, Phillips RK. Topical glyceryl trinitrate in the treatment of chronic anal fissure. Br J Surg 1996; 83: 771-5.
48. Lund JN, Scholefield JH. A randomised, prospective, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure [see comments] [published erratum appears in Lancet 1997 Mar 1;349(9052):656]. Lancet 1997; 349: 11-4.
49. Nelson R. Nonsurgical Therapy for Anal Fissure. The Cochrane Library, issue 1. Chichester, UK: John Wiley and Sons, 2004.
50. Dorfman G, Levitt M, Platell C. Treatment of chronic anal fissure with topical glyceryl trinitrate. Dis Colon Rectum 1999; 42: 1007-10.
51. Jonas M, Barrett DA, Shaw PN, Scholefield JH. Systemic levels of glyceryl trinitrate following topical application to the anoderm do not correlate with measured reduction in anal pressure. Br J Surg 2001; 88: 1613-6.
52. Carapeti EA, Kamm MA, Evans BK, Phillips RK. Topical diltiazem and bethanechol decrease anal sphincter pressure without side effects. Gut 1999; 45: 719-22.
53. Griffin N, Acheson AG, Jonas M, Scholefield JH. The role of topical diltiazem in the treatment of chronic anal fissures that have failed glyceryl trinitrate therapy. Colorectal Dis 2002; 4: 430-5.
54. DasGupta R, Franklin I, Pitt J, Dawson PM. Successful treatment of chronic anal fissure with diltiazem gel. Colorectal Dis 2002; 4: 20-2.
55. Perrotti P, Bove A, Antropoli C, et al. Topical nifedipine with lidocaine ointment vs. active control for treatment of chronic anal fissure: results of a prospective, randomized, double-blind study. Dis Colon Rectum 2002; 45: 1468-75.
56. Torrabadella L, Salgado G, Burns RW, Berman IR. Manometric study of topical sildenafil (Viagra) in patients with chronic anal fissure: sildenafil reduces anal resting tone. Dis Colon Rectum 2004; 47: 733-8.
57. Minguez M, Melo F, Espi A, et al. Therapeutic effects of different doses of botulinum toxin in chronic anal fissure. Dis Colon Rectum 1999; 42: 1016-21.
58. Simons AJ, Beart RW Jr. Glyceryl trinitrate for anal fissure. Lancet 1996; 348: 491-2.
59. Jost WH, Schimrigk K. Botulinum toxin in therapy of anal fissure. Lancet 1995; 345: 188-9.
60. Minguez M, Herreros B, Espi A, et al. Long-term follow-up (42 months) of chronic anal fissure after healing with botulinum toxin. Gastroenterology 2002; 123: 112-7.
61. Hallett M. One man's poison - clinical applications of botulinum toxin. N Engl J Med 1999; 341: 118-20.
62. Jost WH. One hundred cases of anal fissure treated with botulin toxin: early and long-term results. Dis Colon Rectum 1997; 40: 1029-32.
63. Essani R, Sarkisyan G, Beart RW, Ault G, Vukasin P, Kaiser AM. Cost-saving effect of treatment algorithm for chronic anal fissure: a prospective analysis. J Gastrointest Surg 2005; 9: 1237-44.
64. Maria G, Brisinda G, Bentivoglio AR, Cassetta E, Gui D, Albenese A. Influence of botulinum toxin site of injections on healing rate in patients with chronic anal fissure. Am J Surg 2000; 179: 46-50.
65. Goodsall DH, Miles WE. Diseases of the Anus and Rectum, part I. London: Longmans, Green and Co., 1900.
66. Hawley PR. The treatment of chronic fissure-in-ano. A trial of methods. Br J Surg 1969; 56: 915-8.
67. Graham-Stewart CW, Greenwood RK, Lloyd-Davies RW. A review of 50 patients with fissure in ano. Surg Gynecol Obstet 1961; 113: 445-8.
68. Watts JM, Bennett RC, Goligher JC. Stretching of anal sphincters in treatment of fissure-in-ano. Br Med J 1964; 5405: 342-3.
69. Konsten J, Baeten CG. Hemorrhoidectomy vs. Lord's method: 17-year follow-up of a prospective, randomized trial. Dis Colon Rectum 2000; 43: 503-6.
70. Renzi A, Brusciano L, Pescatori M, et al. Pneumatic balloon dilatation for chronic anal fissure: a prospective, clinical, endosonographic, and manometric study. Dis Colon Rectum 2005; 48: 121-6.
71. Eisenhammer S. The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 1951; 25: 486-9.
72. Eisenhammer S. The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure. Surg Gynecol Obstet 1959; 109: 583-90.
73. Brossy JJ. Anatomy and surgery of anal fissure; with special reference to internal sphincterotomy. Ann Surg 1956; 144: 991-8.
74. Abcarian H. Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs. fissurectomy-midline sphincterotomy. Dis Colon Rectum 1980; 23: 31-6.
75. Parks AG. The management of fissure-in-ano. Hosp Med 1967; 1: 737-43.
76. Notaras MJ. Lateral subcutaneous sphincterotomy for anal fissure - a new technique. Proc R Soc Med 1969; 62: 713.
77. Lewis TH, Corman ML, Prager ED, Robertson WG. Long-term results of open and closed sphincterotomy for anal fissure. Dis Colon Rectum 1988; 31: 368-71.
78. Garcia-Aguilar J, Belmonte C, Wong WD, Lowry AC, Madoff RD. Open vs. closed sphincterotomy for chronic anal fissure: long-term results. Dis Colon Rectum 1996; 39: 440-3.
79. Wiley M, Day P, Rieger N, Stephens J, Moore J. Open vs. closed lateral internal sphincterotomy for idiopathic fissure-in-ano: a prospective randomized controlled trial. Dis Colon Rectum 2004; 47: 847-52.
80. Littlejohn DR, Newstead GL. Tailored lateral sphincterotomy for anal fissure. Dis Colon Rectum 1997; 40: 1439-42.
81. Mentes BB, Ege B, Leventoglu S, Oguz M, Karadag A. Extent of lateral internal sphincterotomy: up to the dentate line or up to the fissure apex? Dis Colon Rectum 2005; 48: 365-70.
82. Sultan AH, Kamm MA, Nicholls RJ, Bartram CI. Prospective study of the extent of internal anal sphincter division during lateral sphincterotomy. Dis Colon Rectum 1994; 37: 1031-3.
83. Sze EH. Anal incontinence among women with one versus two complete third-degree perineal lacerations. Int J Gynaecol Obstet 2005; 90: 213-7.
84. Casillas S, Hull TL, Zutshi M, Trzcinski R, Bast JF, Xu M. Incontinence after a lateral internal sphincterotomy: are we underestimating it? Dis Colon Rectum 2005; 48: 1193-9.
85. Singh B, McCMortensen NJ, Jewell JP, George B. Perianal Crohn's disease. Br J Surg 2004; 91: 801-14.
86. Garcia-Granero E, Sanahuja A, Garcia-Armengol J, et al. Anal endosonographic evaluation after closed lateral subcutaneous sphincterotomy. Dis Colon Rectum 1998; 41: 598-601.
87. Engel AF, Eijsbouts QA, Balk AG. Fissurectomy and isosorbide dinitrate for chronic fissure in ano not responding to conservative treatment. Br J Surg 2002; 89: 79-83.
88. Lindsey I, Francis C, Cunningham C, Jones OM, Mortensen NJ. Fissurectomy plus botulinum toxin: a novel sphincter-sparing procedure for medically-resistant chronic anal fissure. Colorectal Dis 2003; 5 (Suppl. 1): 1.
89. Lindsey I, Cunningham C, Jones OM, Francis C, Mortensen NJ. Fissurectomy-botulinum toxin: a novel sphincter-sparing procedure for medically resistant chronic anal fissure. Dis Colon Rectum 2004; 47: 1947-52.
90. Bernard D, Morgan S, Tasse D. Selective surgical management of Crohn's disease of the anus. Can J Surg 1986; 29: 318-21.
91. Fleshner PR, Schoetz DJ Jr, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC. Anal fissure in Crohn's disease: a plea for aggressive management. Dis Colon Rectum 1995; 38: 1137-43.
92. Ouraghi A, Nieuviarts S, Mougenel JL, et al. Infliximab therapy for Crohn's disease anoperineal lesions. Gastroenterol Clin Biol 2001; 25: 949-56.
93. Sweeney JL, Ritchie JK, Nicholls RJ. Anal fissure in Crohn's disease. Br J Surg 1988; 75: 56-7.
94. Wolkomir AF, Luchtefeld MA. Surgery for symptomatic hemorrhoids and anal fissures in Crohn's disease. Dis Colon Rectum 1993; 36: 545-7.
95. Yamamoto T, Allan RN, Keighley MR. Effect of fecal diversion alone on perianal Crohn's disease. World J Surg 2000; 24: 1258-62; discussion 62-3.
96. Di Castro A, Biancari F, D'Andrea V, Caviglia A. Fissurectomy with posterior midline sphincterotomy and anoplasty (FPSA) in the management of chronic anal fissures. Surg Today 1997; 27: 975-8.
97. Nyam DC, Wilson RG, Stewart KJ, Farouk R, Bartolo DC. Island advancement flaps in the management of anal fissures. Br J Surg 1995; 82: 326-8.
98. Madoff RD, Fleshman JW. AGA technical review on the diagnosis and care of patients with anal fissure. Gastroenterology 2003; 124: 235-45.