[Local treatment of a chronic anal fissure with diltiazem vs. nitroglycerin. A comparative study].
نویسندگان
چکیده
AIM To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF). METHODS Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard measures (ST) in two consecutive periods. During the first period they were allocated alternatively to not receive further treatment (ST group) or to be treated with nitroglycerin ointment (NTG group). In the second period all were treated with local diltiazem (DTZ group). One hundred forty-five patients entered the study and 124 completed it. RESULTS Initially there were significant differences in improvement rates (45% ST, 62.5% NTG and 80% DTZ, p<0.01), but not in the cure rates (27% ST, 40% NTG and 39% DTZ) and the treatment was completed by 124 patients (85.5%). There were more side effects and more dropouts in the NTG group. In the subsequent follow-up for a median period of 25 months there were 25% recurrences and almost all responded to repeated medical treatment. CONCLUSIONS Smooth muscle relaxant drugs do not achieve a higher cure rate than the traditional measures used in CAF, but offer more symptomatic relief, providing an opportunity to avoid surgery. Topical diltiazem does not have the side effects of the nitroglycerin and is better accepted by patients.
منابع مشابه
مقایسه تأثیر دیلتیازم ونیتر و گلیسیرین موضعی بر درمان فیشر آنال مزمن
Introduction: Chronic anal fissure is associated with anal hypertonia and considerable pain. Internal sphincter pressure decreases with surgical procedures or medical agents. Numerous clinical studies have evaluated the effectiveness of multiple drugs. Objective: This study compared the efficacy of diltiazem 2% compared to glycerol trinitrate 0.2% for chemical sphincterotomy. Materials & Me...
متن کاملمقایسه اثر درمان جراحی اسفنکتروتومی داخلی و درمان طبی با ژل دیلتیازم در شقاق مزمن مقعد
Comparison Between the Therapeutic Effects of Internal Sphincterotomy and Diltiazem Gel in Chronic Anal Fissure M.A. Rajabi MD Received: 15/08/06 Sent for Revision: 18/10/06 Received Revised Manuscript: 15/05/07 Accepted: 29/05/07 Background and Objective: Surgery is now the "treatment of choice" for chronic anal fissure. However, considering the pathogenesis of this disease and the tendency fo...
متن کاملTopical Diltiazem versus topical Glyceryl trinitrate (GTN) in the treatment of chronic anal fissure: Prospective study
متن کامل
Chronic Anal Fissure: A Comparative Study of Medical Treatment Versus Surgical Sphincterotomy.
To determine whether the medical Treatment of anal fissure can be an effective alternative for surgery Methods: Retrospectively, we randomly selected 190 Patients being treated for anal fissure between the years 2005-2010 in 3 equal groups: group A: Patients who received medical treatment with topical nitroglycerin, group B: Patient treated with topical diltiazem, and group C: Patients underwen...
متن کاملTopical diltiazem hydrochloride and glyceryl trinitrate in the treatment of chronic anal fissure.
OBJECTIVE To compare the symptomatic relief, healing and side-effects of topical diltiazem (DTZ) and glyceryl trinitrate in the treatment of chronic anal fissure. STUDY DESIGN Randomized controlled trial. PLACE AND DURATION OF STUDY The Surgical Outpatient Department of Civil Hospital, Karachi, from March 2006 to February 2007. METHODOLOGY Patients with chronic anal fissure were included ...
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عنوان ژورنال:
- Cirugia espanola
دوره 87 4 شماره
صفحات -
تاریخ انتشار 2010