The management of patients with primary chronic anal fissure: A position paper

Techniques in Coloproctology

Volumn 15, Issue 2, 2011, Pages 135-141

  Altomare, D F ^a   Binda, G A ^b   Canuti, S ^c   Landolfi, V ^d   Trompetto, M ^e   Villani, R D ^f  

^a UNIVERSITY OF BARI MEDICAL SCHOOL   (Italy)

^b GALLIERA HOSPITAL   (Italy)

^c General Surgery Unit   (Italy)

^d A Landolfi Hospital   (Italy)

^e S Rita Hospital   (Italy)

^f Sassuolo Hospital   (Italy)

Author keywords

Anal fissure; Botulinum toxin; Calcium channel blockers; Glyceryl trinitrate; Sphincterotomy

Indexed keywords

BOTULINUM TOXIN; CALCIUM CHANNEL AFFECTING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DILTIAZEM; GLYCERYL TRINITRATE; HYDROCORTISONE PLUS LIDOCAINE; LIDOCAINE PLUS NIFEDIPINE; NIFEDIPINE; NITRATE; PLACEBO; UNCLASSIFIED DRUG;

ABSCESS; ANUS FISSURE; BEHAVIOR THERAPY; CHRONIC DISEASE; COMPARATIVE EFFECTIVENESS; CONSERVATIVE TREATMENT; DISEASE ASSOCIATION; DOSAGE SCHEDULE COMPARISON; DRUG DOSAGE FORM COMPARISON; DRUG RESPONSE; DRUG TOLERABILITY; EVIDENCE BASED MEDICINE; FECES INCONTINENCE; FISTULA; HEADACHE; HEMATOMA; HUMAN; INTERMETHOD COMPARISON; MIGRAINE; MUSCLE HYPERTONIA; PAIN ASSESSMENT; POSTOPERATIVE HEMORRHAGE; PRURITUS; QUALITY OF LIFE; REVIEW; SKIN INFECTION; SPHINCTEROTOMY; SURGICAL APPROACH; SYSTEMIC DISEASE; TREATMENT DURATION; TREATMENT PLANNING;

ANAL CANAL; BOTULINUM TOXINS; CALCIUM CHANNEL BLOCKERS; CHRONIC DISEASE; FISSURE IN ANO; HUMANS; NITROGLYCERIN; VASODILATOR AGENTS;

EID: 80051663855     PISSN: 11236337     EISSN: 1128045X     Source Type: Journal    
DOI: 10.1007/s10151-011-0683-7     Document Type: Review

References (77)

1. Cross KL, Massey EJDA, Fowler AL, Monson JRT (2008) The management of anal fissure: ACPGBI position statement. Colo-rectal Dis 10(Suppl 3):1-7
2. Orsay C, Rakinic J, Perry Brian W et al (2004) ASCRS practical parameters for the management of anal fissures. Dis Colon Rectum 47:2003-2007 (Pubitemid 40179057)
3. CKS/NHS Anal fissure, http://www.cks.nhs.uk/anal-fissure#-314 748
4. Lund JN, Scholefield JH (1996) Aetiology and treatment of anal fissure. Br J Surg 83:1335-1344 (Pubitemid 26342149)
5. Goligher JC (1975) Surgery of the anus, Rectum & Colon, 3rd edn. Balliere & Tindall, London
6. American Gastroenterology Association (AGA) (2003) American gastroenterological association medical position statement: diagnosis and care of patients with anal fissure. Gastroenterology 124:233-234
7. Collins EE, Lund NJ (2007) A review of chronic anal fissure management. Tech Coloproctol 11:209-223 (Pubitemid 47459911)
8. Lindsey I, Jones OM, Cunningham C, Mortensen NJ (2004) Chronic anal fissure. Br J Surg 91:270-279 (Pubitemid 38379655)
9. Hananel N, Gordon PH (1997) Re-examination of clinical manifestation and response to therapy of fissure-in-ano. Dis Colon Rectum 40:229-233 (Pubitemid 27074297)
10. Steele SR, Madoff RD (2006) Systematic review: treatment of anal fissure. Aliment Pharmacol Ther 24:247-257 (Pubitemid 43972893)
11. Notaras MJ (1988) Anal fissure and stenosis. Surg Clin North Am 68:1427-1440 (Pubitemid 19002299)
12. Lock MR (1977) Thompson JPS Fissure-in-ano: the initial management and prognosis. Br J Surg 84:86-88
13. Hospital Episode Statistics (2007) Hospital Episode Statistics 2005/2006. Department of Health. National Institute for Health and Clinical Excellence. www.hesonline.nhs.uk
14. SICCR Annual Report (2009). www.siccr.org
15. Ball C (1908) The rectum, its diseases and developmental defects. Hodder and Stoughton, London
16. Brodie BC (1835) Lectures on diseases of the rectum: preternatural contraction of the sphincter ani. Lond Med Gazette 16:26-31
17. Hancock BD (1977) The internal sphincter and anal fissure. Br J Surg 64:92-95 (Pubitemid 8033203)
18. Favetta U, Amato A, Interisano A, Pescatori M (1996) Clinical, monometric and sonographic assessment of the anal sphincters. A comparative prospective study. Int J Colorectal Dis 11:163-166 (Pubitemid 26275833)
19. Bove A, Balzano A, Perrotti P, Antropoli C, Lombardi G, Puc-ciani F (2004) Different anal pressure profiles in patients with anal fissure. Tech Coloproctol 8:151-156 (Pubitemid 40174548)
20. Corby H, Donnelly VS, O'Herlihy C, O'Connell PR (1997) Anal canal pressures are low in women with postpartum anal fissure. Br J Surg 84:86-88 (Pubitemid 27033115)
21. Rattan S, Chakder S (1992) Role of nitric oxide as a mediator of internal anal sphincter relaxation. Am J Physiol 262:G107-G112
22. Lund J (2006) Nitric oxide deficiency in the internal anal sphincter of patients with chronic anal fissure. Int J Colorectal Dis 21:673-675 (Pubitemid 44446070)
23. Schouten WR, Briel JW, Auwerda JJ (1994) Relationship between anal pressure and anodermal blood flow. Dis Colon Rectum 37:664-669
24. Schouten WR, Briel JW, Auwerda JJ, De Graaf EJ (1996) Ischaemic nature of anal fissure. Br J Surg 83:63-65 (Pubitemid 26018808)
25. Kua KB, Kocker HM, Kelkar A, Patel AG (2001) Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures. ANZ J Surg 71:548-550 (Pubitemid 32848248)
26. Jones OM, Ramalligam T, Lindsey I, Cunningham C, George BD, Mortensen NJ (2005) Digital rectal examination of sphincter pressures in chronic anal fissure is unreliable. Dis Colon Rectum 48:349-352 (Pubitemid 40576569)
27. Jensen SL (1986) Treatment of first episodes of acute anal fissure: prospective randomised study of lignocaine ointment versus hydrocortisone ointment or warm sitz baths plus bran. BMJ 292:1167-1169 (Pubitemid 16104642)
28. Jiang JK, Chiu JH, Lin JK (1999) Local thermal stimulation relaxes hypertonic anal sphincter: evidence of somatoanal reflex. Dis Colon Rectum 42:1152-1159
29. Gough MJ, Lewis A (1983) The conservative treatment of fissure-in-ano. Br J Surg 70:175-176 (Pubitemid 13153363)
30. Jensen SL (1987) Maintenance therapy with unprocessed bran in the prevention of acute anal fissure recurrence. J R Soc Med 80:296-298 (Pubitemid 17122628)
31. Loder PB, Kamm MA, Nicholls RJ, Phillips RK (1984) Reversible chemical sfincterotomy by local application of glyceryl trinitrate. Br J Surg 81:1386-1389
32. Lund JN, Nystrom PO, Coremans G et al (2006) An evidence-based treatment algorithm for anal fissure. Tech Coloproctol 10:177-180 (Pubitemid 44546796)
33. Gorfine SR (1995) Topical nitroglycerin therapy for anal fissures and ulcers. N Engl J Med 333:1156-1157
34. Lund JN, Armitage NC, Scholefield JH (1996) Use of glyceryl trinitrate ointment in the treatment of anal fissure. Br J Surg 83:776-777 (Pubitemid 26000061)
35. Kennedy ML, Sowter S, Nguyen H, Lubowski DZ (1999) Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo-controlled trial and long-term follow-up. Dis Colon Rectum 42:1000-1006 (Pubitemid 29383827)
36. Bailey HR, Beck DE, Billingham RP et al (2002) A study to determine the nitroglycerin ointment dose and dosing interval that best promote the healing of chronic anal fissures. Dis Colon Rectum 45:1192-1199
37. Altomare DF, Rinaldi M, Milito G et al (2000) Glyceryl trinitrate for chronic anal fissure-healing or headache? Results of a mul-ticenter, randomized, placebo-controlled, double-blind trial. Dis Colon Rectum 43:174-179
38. Lund JN, Scholefield JH (1997) A randomised, prospective, double blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure [published erratum appears in Lancet 349:656]. Lancet 349:11-14 (Pubitemid 27022984)
39. Nelson R (2004) A systematic review of medical therapy for anal fissure. Dis Colon Rectum 47:422-431 (Pubitemid 38436646)
40. Griffin N, Acheson AG, Tung P, Sheard C, Glazebrook C, Scholefield JH (2004) Quality of life in patients with chronic anal fissure. Colorectal Dis 6:39-44 (Pubitemid 38195492)
41. Graziano A, Svidler Lopez L, Lencinas S, Masciagnoli G, Gualdrini U, Bisisio O (2001) Long-term results of topical nitroglycerin in the treatment of chronic anal fissures are disappointing. Tech Coloproctol 5:143-147 (Pubitemid 34151622)
42. Nelson R (2006) Non surgical therapy for anal fissure. Cochrane Database Syst Rev 18:CD003431
43. Fenton C, Wellington K, Easthope SE (2006) 0.4% nitroglycerin ointment in the treatment of chronic anal fissure pain. Drugs 66:343-349 (Pubitemid 46291769)
44. Gagliardi G, Pascariello A, Altomare DF et al (2010) Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial. Tech Col-oproctol 14:241-248
45. Sands LR (2006) 0.4% nitroglycerin ointment in the treatment of chronic anal fissure pain: a viewpoint by Laurence R. Sands. Drugs 66:350-352
46. Knight JS, Birks M, Farouk R (2001) Topical diltiazem ointment in the treatment of chronic anal fissure. Br J Surg 88:553-556 (Pubitemid 32291237)
47. Carapeti EA, Kamm MA, Phillips RK (2000) Topical diltiazem and bethanechol decrease anal sphincter pressure and heal anal fissures without side effects. Dis Colon Rectum 43:1359-1362
48. Bielecki K, Kolodziejczak M (2003) A prospective randomized trial of diltiazem and glyceryl trinitrate ointment in the treatment of chronic anal fissure. Colorectal Dis 5:256-257 (Pubitemid 36626151)
49. Nash GF, Kapoor K, Saeb-Parsy K, Kunanandam T, Dawson PM (2006) The long-term results of diltiazem treatment for anal fissure. Int J Clin Pract 60:1411-1413 (Pubitemid 44560339)
50. Perrotti P, Bove A, Antropoli C et al (2002) Topical nifedipine with lidocaine ointment vs. active control for treatment of chronic anal fissure: results of a prospective, randomized, doubleblind study. Dis Colon Rectum 45:1468-1475 (Pubitemid 35345872)
51. Merenstein D, Rosenbaum D (2003) Is topical nifedipine effective for chronic anal fissures? J Fam Pract 52:190-192
52. Ezri T, Susmallian S (2003) Topical nifedipine vs topical glyceryl trinitrate for treatment of chronic anal fissure. Dis Col Rectum 46:805-808 (Pubitemid 36693401)
53. Jost WH (1997) One hundred cases of anal fissure treated with botulinum toxin: early and long-term results. Dis Colon Rectum 40:1029-1032 (Pubitemid 27377578)
54. Maria G, Brisinda G, Bentivoglio AR, Cassetta A, Gui D, Alb-anese A (2000) Influence of botulinum toxin site of injections on healing rate in patients with chronic anal fissure. Am J Surg 179:46-50 (Pubitemid 30126009)
55. Minguez M, Melo F, Espi A et al (1999) Therapeutic effects of different doses of botulinum toxin in chronic anal fissure. Dis Colon Rectum 42:1016-1021 (Pubitemid 29383830)
56. Essani R, Sarkisyan G, Beart RW, Ault G, Vukasin P, Kaiser AM (2005) Cost-saving effect of treatment algorithm for chronic anal fissure: a prospective analysis. J Gastrointest Surg 9:1237-1244 (Pubitemid 41751116)
57. Arroyo A, Perez F, Serrano P et al (2005) Long-term results of botulinum toxin for the treatment of chronic anal fissure: prospective clinical and manometric study. Int J Colorectal Dis 20:267-271 (Pubitemid 40553007)
58. Brisinda G, Maria G, Sganga G, Bentivoglio AR, Albanese A, Castagneto M (2002) Effectiveness of higher doses of botulinum toxin to induce healing in patients with chronic anal fissures. Surgery 131:179-184 (Pubitemid 34169544)
59. Maria G, Cassetta E, Gui D, Brisinda G, Bentivoglio AR, Alb-anese A (1998) A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. N Engl J Med 338:217-220 (Pubitemid 28047574)
60. Fruehauf H, Fried M, Wegmueller B, Bauerfeind P, Thumshirn M (2006) Efficacy and safety of botulinum toxin compared with topical nytroglycerin oinment for the treatment of chronic anal fissure: a prospective randomized study. Am J Gastroenterol 101:2107-2112 (Pubitemid 44337637)
61. Watts JM, Bennett RC, Goligher JC (1964) Streching of anal sphincters in treatment of fissure-in-ano. Br Med J 2:342-343
62. Sohn N, Eisenberg MM, Weinstein MA, Lugo RN, Ader J (1992) Precise anorectal sphincter dilatation-its role in the therapy of anal fissure. Dis Colon Rectum 35:322-327
63. Marby M, Alexander-Williams J, Buchmann P et al (1979) A randomized controlled trial to compare anal dilatation with lateral subcutaneous sphincterotomy for anal fissure. Dis Colon Rectum 22:308-311 (Pubitemid 10220376)
64. Jensen SL, Lund F, Nielsen OV, Tange G (1984) Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in outpatients. A prospective randomized study. BMJ 289:528-530 (Pubitemid 14002080)
65. Nielsen MB, Rasmussen OO, Pedersen JF, Christiansen J (1993) Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano. An endosonographic study. Dis Colon Rectum 36:677-680 (Pubitemid 23206323)
66. Renzi A, Brusciano L, Pescatori M et al (2005) Pneumatic balloon dilation for chronic anal fissure: a prospective, clinical, endosonographic, and manometric study. Dis Colon Rectum 48:121-126
67. Yucel T, Gonullu D, Oncu M, Koksoy FN, Ozkan SG, Aycan O (2009) Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective, randomized study. Int J Surg 7:228-231
68. Abcarian H (1980) Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs fissurectomy-midline sphincterotomy. Dis Colon Rectum 23:31-36 (Pubitemid 10131559)
69. McDonald P, Driscoll AM, Nicholls RJ (1983) The anal dilator in the conservative management of acute anal fissures. Br J Surg 70:25-26 (Pubitemid 13176023)
70. Hawley PR (1969) The treatment of chronic fissure-in-ano. A trial of methods. Br J Surg 56:915-918
71. Karamanlis E, Michalopoulos A, Papadopoulos V et al. (2010) Prospective clinical trial comparing sphincterotomy, nitroglyc-erin ointment and xylocaine/lactulose combination for the treatment of anal fissure. Tech Coloproctol 14(Suppl 1):S21-S23
72. Boulous PB, Araujo JG (1984) Adeguate internal sphincterotomy for chronic anal fissure: subcutaneous or open technique? Br J Surg 71:360-362 (Pubitemid 14137713)
73. Kortbeek JB, Langevin JM, Khoo RE, Heine JA (1992) Chronic fissure in ano: a randomized study comparing open and subcutaneous lateral internal sphincterotomy. Dis Colon Rectum 35:835-837
74. Altomare DF, Rinaldi M, Troilo VL, Marino F, Lobascio P, Puglisi F (2005) Closed ambulatory lateral internal sphincterot-omy for chronic anal fissures. Tech Coloproctol 9:248-249 (Pubitemid 41772345)
75. Garcia-Aguilar J, Belmonte C, Wong WD, Lowry AC, Madoff RD (1996) Open vs. closed sphincterotomy for chronic anal fissure: long-term results. Dis Colon Rectum 39:440-443 (Pubitemid 26116876)
76. Leong AF, Seow-Choen F (1995) Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure. Dis Colon Rectum 38:69-71
77. Bhardwaj R, Parker MC (2007) Modern perspectives in the management of chronic anal fissures. Ann R Coll Surg Engl 89:472-478 (Pubitemid 47061847)