Comparison of topical glyceryl trinitrate with diltiazem ointment for treatment of chronic anal fissure. A randomized clinical trial.
نویسندگان
چکیده
BACKGROUND The aim of this study was to compare the effect of topical glycerol trinitrate ointment (GTN) with topical diltiazem hydrochloride ointment (DTZ) in the treatment of chronic anal fissure. METHOD Prospectively, 102 patients were treated randomly with either GTN ointment (0.2%) or DTZ ointment (2%) couple of times daily for 12 weeks. RESULTS Forty-five patients (88.2%) in group DTZ and 36 patients (70.6%) in group GTZ had reduction of symptoms. The decrease in the symptoms for group DTZ were significantly more than that for group GTN (P = 0.02). Mean time of symptom reduction was 2.44 +/- 0.30 in group DTZ and 2.50 +/- 0.28 weeks in group GTN without significant differences between two groups (P > 0.05). Complete relieving of symptoms was observed in 72.5%, 54.9% patients in groups DTZ and GTN, respectively. The frequency of complete relieving of symptoms between two groups was not significant (P > 0.05). Complete remission of anal fissure was occurred in 66.7% patients in group DTZ and 54.9% patients in group GTN, which was no different, significantly. Mean time taken for fissure healing in GTN group was dramatically less than DTZ group (P = 0.001). Finally, 33.3% of patients in DTZ group and 45.1% of patients in GTN group was operated. The need for operation was not significant between two groups (P > 0.05). CONCLUSION Both DTZ and GTN are equally effective and can be the preferred first-line treatment of chronic anal fissure a. However, GTN is associated with a higher rate of headache, and it should be replaced by DTZ.
منابع مشابه
Topical 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 ...
متن کاملمقایسه 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 کاملOutcome Of 0.2% Glyceryltrinitrate Cream Versus 2% Diltiazem Cream In The Treatment Of Chronic Anal Fissure.
BACKGROUND Anal fissure is a linear tear in the distal anal canal resulting from persistent hypertonia and spasm of the internal sphincter which results in mucosal ischemia. We have conducted a study in order to compare the outcome of 0.2% glyceryl trinitrate cream versus 2% diltiazem cream in the treatment of chronic anal fissure. METHODS This randomized controlled trial (RCT) was carried ou...
متن کاملTopical Diltiazem versus topical Glyceryl trinitrate (GTN) in the treatment of chronic anal fissure: Prospective study
متن کامل
Diltiazem vs. glyceryl tri-nitrate for symptomatic relief in anal fissure: a randomised clnical study.
OBJECTIVE To further resolve the clinical equipoise on the choice of chemical sphincterotomy agent for early symptomatic relief of anal fissure by comparing the effectiveness of 2% Diltiazem gel with 0.2% Glyceryl TriNitrate. METHODS The randomized clinical trial was conducted at Aga Khan University Hospital, Karachi, from February 1, to July 30, 2008, and comprised 60 adult patients with ana...
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ورودعنوان ژورنال:
- Annali italiani di chirurgia
دوره 80 5 شماره
صفحات -
تاریخ انتشار 2009