Purpose: Lateral internal sphincterotomy has been the gold standard treatment for chronic anal fissure, but it still carries the risk of permanent damage of the anal sphincter, which has led to the implementation of alternative treatment like botulinum toxin injection. The aim of this randomized prospective controlled trial was to compare the efficacy and morbidity of botulinum toxin injection and lateral internal sphincterotomy in the treatment of chronic anal fissure.
Methods: Fifty consecutive adults with chronic anal fissure were randomly treated with either lateral internal sphincterotomy or botulinum toxin (BT) injection with 50 U BT into the internal sphincter. The complications, healing and recurrence rate, and incontinence score were assessed 2, 3, 6, 12 months after the procedure.
Results: Inspection at the 2-month visit revealed complete healing of the fissure in 11 (44 %) of the patients in the BT group and 22 (88 %) of the patients in the lateral internal sphincterotomy (LIS) group (p = 0.001). At the 3-month visit, there was no significant difference between the two groups in healing. The overall recurrence rate after 6 months in the BT group was higher than in the LIS group (p < 0.05). In the 3-month follow-up, the LIS group had a higher rate of anal incontinence compared to the BT group (p < 0.05). The final percentage of incontinence was 4 % in the LIS group (p > 0.05).
Conclusions: The treatment of chronic anal fissure must be individualized depending on the different clinical profiles of patients. Botulinum toxin injection has a higher recurrence rate than LIS, and LIS provides rapid and permanent recovery. However, LIS carries a higher risk of anal incontinence in patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00423-012-0948-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical study on the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes.
World J Diabetes
January 2025
Department of General Thoracic Surgery, Liaoning Electric Power Center Hospital, Shenyang 110000, Liaoning Province, China.
Background: At present, the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent, to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes, the report is as follows.
Aim: To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus (T2DM).
Methods: We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated jejunoileal lateral anastomosis.
Implications of Hemispheric Shift of Sensory Feedback during Post-stroke Motor Control on Personalized Stroke Rehabilitation.
Converg Clin Eng Res Neurorehabilit V (2024)
December 2024
University of Illinois Urbana-Champaign, Urbana, IL, USA; Carle Foundation Hospital, Urbana, IL, USA; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA.
Sensory feedback is crucial for motor control as it establishes the internal representation of motion. This study investigates changes in sensory feedback in hemiparetic stroke by analyzing the laterality index (LI) of somatosensory evoked potentials (SEPs) during movements of the paretic arm, focusing on a shift from the lesioned to the contralesional hemisphere. Three chronic stroke participants performed isometric lifts of their paretic arms at two different levels of their maximum voluntary contraction while receiving tactile finger stimulation.
View Article and Find Full Text PDFTreatment of posterolateral tibial plateau fractures through the articular line approach.
BMC Musculoskelet Disord
January 2025
Department of Orthopedics, Lishui Central Hospital, Zhejiang, 323000, China.
Background: Posterolateral tibial plateau fractures pose significant challenges for orthopedic surgeons due to the anatomical risks associated with the posterolateral approach. Despite numerous surgical techniques available, there lacks a consensus on the optimal approach.
Methods: Articular line incision approach was employed on 12 patients suffering from posterolateral tibial plateau fractures.
Foot tissue stress in chronic ankle instability during the stance phase of cutting.
Med Biol Eng Comput
January 2025
Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
Lower limb biomechanics of chronic ankle instability (CAI) individuals has been widely investigated, but few have evaluated the internal foot mechanics in CAI. This study evaluated bone and soft tissue stress in CAI contrasted with copers and non-injured participants during a cutting task. Integrating scanned 3D foot shapes and free-form deformation, sixty-six personalized finite element foot models were developed.
View Article and Find Full Text PDFSpine-Abductor Syndrome: Novel Associations Between Lumbar Spine Disease and Hip Gluteal Muscle Pathology.
J Bone Joint Surg Am
November 2024
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!