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2008, Number 2

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Rev Hosp Jua Mex 2008; 75 (2)

Fisura anal: Alternativas de tratamiento farmacológico

Rodríguez WU

Language: Spanish
References: 30
Page: 122-125
PDF size: 147.92 Kb.


ABSTRACT

Anal fissure is an oval, ulcer like lesion in the anoderm, strong overdistention of the anal canal is the main factor in this lesion, anal fissures are associated with hypertonia of the anal canal and a reduction in blood flow, with poor healing tendency. Some pharmacological therapies have been proposed, because surgery carries a low risk of minor fecal incontinence. Between these therapies, the most used are: nitroglycerin, isosorbide dinitrate, nifedipine, diltiazem, and botulinum toxin. In case of severe anal fissure or when pharmacologic manipulation failed, fissures could be treated by surgery.


REFERENCES

  1. Bailey HR, Beck DE, Billingham RP, et al. A study to determine the nitroglycerin ointment dose and dosing interval that best promote the healing of chronic anal fissures. Dis Colon Rectum 2002; 45: 1192-9.

  2. Rodríguez-Wong U. Fisura anal. Rev Hosp Jua Mex 1992; 59: 88-90.

  3. Rodríguez-Wong U. Manometría ano-rectal, perspectivas actuales. Rev Hosp Jua Mex 2006; 73: 28-32.

  4. Arabi Y, Alexander-Williams J, Keighley MRB. Anal pressures in hemorrhoids and anal fissures. Am J Surg 1977; 134: 608.

  5. Hancock BD. The internal sphincter and anal fissure. Br J Surg 1977; 64: 92-5.

  6. Farouk R, Duthie GS, McGregor AB, Bartolo DC. Sustained internal sphincter hypertonia in patients with chronic anal fissure. Dis Colon Rectum 1994; 37: 424-9.

  7. Schouten WR, Briel JW, Auwerda JJ, De Graaf EJ. Ischaemic nature of anal fissure. Br J Surg 1996; 83: 63-5.

  8. Hicks TC, Timmcke A. Fisura anal. En: Zuidema “Shackelford’s Surgery of the Alimentary Tract”. Philadelphia, PA: WB Saunders Co.; 1991; 4: 351-7.

  9. Orsay C, Rakinic J, Perry B, Hyman N, Buie D. Practice parameters for the management of anal fissures (revised). Dis Colon Rectum 2004; 47: 2003-7.

  10. Nelson RL. Meta-analysis of operative techniques for fissurein- ano. Dis Colon Rectum 1999; 42: 1424-31.

  11. Nyam DC, Pemberton JH. Long-term results of lateral internal sphincterotomy for chronic anal fissure with particular reference to incidence of fecal incontinence. Dis Colon Rectum 1999; 42: 1306-10.

  12. Sosa-Gallegos J. Fisura anal. Rev Hosp Jua Mex 2007; 74: 21-6.

  13. Abcarian H. Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs. fissurectomy-Midline sphincterotomy. Dis Colon Rectum 1980; 23: 31-6.

  14. Correa-Rovelo JM, Obregón L, Téllez O. Fisura anal. En: Takahashi T. “Colon, Recto y Ano Enfermedades Médico Quirúrgicas”. Editores de Textos Mexicanos; 2002, p. 304-8.

  15. Carapeti EA, Kamm MA, MacDonald PJ. Randomised controlled trial shows that glyceryl trinitrate helas anal fissures, higher doses are not more effective, and there is a high recurrente rate. Gut 1989; 44: 727-30.

  16. Were AJ, Palamba HW, Bilgen EJ. Isosorbide dinitrate in the treatment of anal fissure: a randomised, prospective, double blind, placebo-controlled trial. Eur J Surg 2001; 167: 382-5.

  17. Bailey HR, Beck DE, Billingham RP, Binderow SR, Gottesman L, Hull TL. A study to determine the nitroglycerin ointment dose and dosing interval that best promote the healing of chronic anal fissures. Dis Colon Rectum 2002; 45: 1192-9.

  18. Altomare DF, Rinaldi M, Milito G. 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.

  19. Evans J, Luck A, Hewett P. Glyceryl trinitrate vs. lateral sphincterotomy for chronic anal fissure: prospective randomised trial. Dis Colon Rectum 2001; 44: 93-7.

  20. Antropoli C, Perrotti P, Rubino M. Nifedipine for local use in conservative treatment of anal fissures : preliminary results of a multicenter study. Dis Colon Rectum 1999; 42: 1011-15.

  21. Jonas M, Neal KR, Abercrombie JF. A randomized trial of oral vs. topical diltiazem for chronic anal fissures. Dis Colon Rectum 2001; 44: 1074-8.

  22. Kocher HM, Steward M, Leather AJ. 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: 413-17.

  23. Tranqui P, Trottier DC, Victor C, Freeman JB. Non surgical treatment of chronic anal fissure: nitroglycerin and dilatation versus nifedipine and botulinum toxin. Can J Surg 2006; 49: 41-5.

  24. Jost WH. One hundres cases of anal fissure treated with botulinum toxin: early and long-term results. Dis Colon Rectum 1997; 40: 1029-32.

  25. Jost WH, Schimrigk L. Therapy of anal fissure using botulinum toxin. Dis Colon Rectum 1994; 37: 1321-4.

  26. Brisinda G, Cadeddu F Brandara F, Marniga G, Vanella S, Nigro C, Maria G. Botulinum toxin for recurrent anal fissure following lateral internal sphincterotomy. Br J Surg 2008: 95: 774-8.

  27. Torrabadell 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.

  28. Zielanowski MM. Topical ketanserin gel for anal fissure: an open-label, prospective study. Adv Ther 2000; 17: 27-31.

  29. Nelson R. A systematic review of medical therapy for anal fissure. Dis Colon Rectum 2004; 47: 422-31.

  30. Nelson R. Non surgical theraphy for anal fissure. Cochrane Database Syst Rev 2006; 4: CD003431.




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