Titre du document / Document title

Topical 0.5% nifedipine vs. lateral internal sphincterotomy for the treatment of chronic anal fissure : long-term follow-up

Auteur(s) / Author(s)

KATSINELOS Panagiotis ⁽¹⁾ ; PAPAZIOGAS Basilios ⁽²⁾ ; KOUTELIDAKIS Ioannis ⁽²⁾ ; PAROUTOGLOU George ⁽¹⁾ ; DIMIROPOULOS Stavros ⁽¹⁾ ; SOUPARIS Anastasios ⁽²⁾ ; ATMATZIDIS Konstantinos ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, 54635 Thessaloniki, GRECE
⁽²⁾ Second Department of Surgery, Central Hospital. Aristoteles University of Thessaloniki, Ethnikis Aminis 41, 54635 Thessaloniki, GRECE

Résumé / Abstract

Background: The aim of this study was to compare the efficacy of the local application of 0.5% nifedipine ointment vs. lateral internal sphincterotomy in the healing of chronic anal fissure. Patients and methods: Sixty-four patients with symptomatic chronic anal fissures were randomly assigned to 0.5% nifedipine ointment (n=32) every 8 h for 8 weeks or lateral internal sphincterotomy (n=32). Both groups received stool softeners and fiber supplements and were assessed at 2, 4, 6, and 8 weeks. Long-term outcomes were determined after a median follow-up of 19 months (nifedipine group) and 20.5 months (lateral internal sphincterotomy group). Results: Complete healing at 8 weeks was achieved in 30 out of 31 patients (96.7%) in the nifedipine group and 32 out of 32 patients (100%) in the lateral internal sphincterotomy group (p=0.49). The overall healing rates at the end of follow-up were 28 out of 30 (93%) vs. 32 out of 32 (100%) in the nifedipine and sphincterotomy groups respectively (p=0.48). Two of the 30 patients in the nifedipine group relapsed whereas none in the sphincterotomy group did. Sixteen patients (50%) developed side effects in the nifedipine group, compared with six patients (18.7%) in the sphincterotomy group. Conclusions: Topical application of 0.5% nifedipine ointment represents a new, promising, easily handled, effective alternative to lateral internal sphincterotomy.

Revue / Journal Title

International journal of colorectal disease   ISSN 0179-1958   CODEN IJCDE6 

Source / Source

2006, vol. 21, n^o2, pp. 179-183 [5 page(s) (article)] (30 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Berlin, ALLEMAGNE  (1986) (Revue)

Mots-clés anglais / English Keywords

Anorectal disease ; Intestinal disease ; Digestive diseases ; Surgery ; Dihydropyridine derivatives ; Calcium antagonist ; Antiarrhythmic agent ; Gastroenterology ; Long term ; Anal fissure ; Chronic ; Treatment ; Sphincterotomy ; Lateral ; Nifedipine ;

Mots-clés français / French Keywords

Anorectale pathologie ; Intestin pathologie ; Appareil digestif pathologie ; Chirurgie ; Dihydropyridine dérivé ; Antagoniste calcium ; Antiarythmique ; Gastroentérologie ; Long terme ; Fissure anale ; Chronique ; Traitement ; Sphinctérotomie ; Latéral ; Nifédipine ;

Mots-clés espagnols / Spanish Keywords

Anorrectal patología ; Intestino patología ; Aparato digestivo patología ; Cirugía ; Dihidropiridine derivado ; Antagonista calcio ; Antiarrítmico ; Gastroenterología ; Largo plazo ; Fisura anal ; Crónico ; Tratamiento ; Esfinteromía ; Lateral ; Nifedipino ;

Mots-clés d'auteur / Author Keywords

Anal fissure ; Nifedipine ; Lateral internal sphincterotomy ;

Localisation / Location

INIST-CNRS, Cote INIST : 20970, 35400013315214.0120