Chronic anal fissure
Background: The treatment of chronic anal fissure has shifted in recent years from surgical to medical. Methods: A Medline search of studies relevant to modern management of chronic anal fissure was undertaken. Results: Traditional surgery that permanently weakens the internal sphincter is associate...
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| Veröffentlicht in: | British journal of surgery 2004-03, Vol.91 (3), p.270-279 |
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| container_end_page | 279 |
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| container_issue | 3 |
| container_start_page | 270 |
| container_title | British journal of surgery |
| container_volume | 91 |
| creator | Lindsey, I. Jones, O. M. Cunningham, C. Mortensen, N. J. McC |
| description | Background:
The treatment of chronic anal fissure has shifted in recent years from surgical to medical.
Methods:
A Medline search of studies relevant to modern management of chronic anal fissure was undertaken.
Results:
Traditional surgery that permanently weakens the internal sphincter is associated with a risk of incontinence. Medical therapies temporarily relax the internal sphincter and pose no such danger, but their limited efficacy has led to displacement rather than replacement of traditional surgery. Emerging medical therapies promise continued improvement and new sphincter‐sparing surgery may render traditional surgery redundant.
Conclusion:
First‐line use of medical therapy cures most chronic anal fissures cheaply and conveniently. The few non‐responders can be targeted for sphincter assessment before traditional surgery. If the initial good results of new sphincter‐sparing surgery are confirmed, it may be possible to avoid any risk of incontinence, while achieving high rates of fissure healing. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Medical treatment first |
| doi_str_mv | 10.1002/bjs.4531 |
| format | Article |
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The treatment of chronic anal fissure has shifted in recent years from surgical to medical.
Methods:
A Medline search of studies relevant to modern management of chronic anal fissure was undertaken.
Results:
Traditional surgery that permanently weakens the internal sphincter is associated with a risk of incontinence. Medical therapies temporarily relax the internal sphincter and pose no such danger, but their limited efficacy has led to displacement rather than replacement of traditional surgery. Emerging medical therapies promise continued improvement and new sphincter‐sparing surgery may render traditional surgery redundant.
Conclusion:
First‐line use of medical therapy cures most chronic anal fissures cheaply and conveniently. The few non‐responders can be targeted for sphincter assessment before traditional surgery. If the initial good results of new sphincter‐sparing surgery are confirmed, it may be possible to avoid any risk of incontinence, while achieving high rates of fissure healing. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Medical treatment first</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.4531</identifier><identifier>PMID: 14991625</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Anal Canal - surgery ; Biological and medical sciences ; Botulinum Toxins, Type A ; Calcium Channel Blockers ; Diltiazem - therapeutic use ; Fecal Incontinence - etiology ; Fissure in Ano - drug therapy ; Fissure in Ano - surgery ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Medical sciences ; Nitric Oxide Donors - therapeutic use ; Nitroglycerin - therapeutic use ; Other diseases. Semiology ; Postoperative Complications - etiology ; Retreatment ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Treatment Failure</subject><ispartof>British journal of surgery, 2004-03, Vol.91 (3), p.270-279</ispartof><rights>Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2004 British Journal of Surgery Society Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3861-2acf4911f81b5fd40ae60a77e64cebc0f22339288e97ffcdd8786c7496a688b03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.4531$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.4531$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15547145$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14991625$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lindsey, I.</creatorcontrib><creatorcontrib>Jones, O. M.</creatorcontrib><creatorcontrib>Cunningham, C.</creatorcontrib><creatorcontrib>Mortensen, N. J. McC</creatorcontrib><title>Chronic anal fissure</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
The treatment of chronic anal fissure has shifted in recent years from surgical to medical.
Methods:
A Medline search of studies relevant to modern management of chronic anal fissure was undertaken.
Results:
Traditional surgery that permanently weakens the internal sphincter is associated with a risk of incontinence. Medical therapies temporarily relax the internal sphincter and pose no such danger, but their limited efficacy has led to displacement rather than replacement of traditional surgery. Emerging medical therapies promise continued improvement and new sphincter‐sparing surgery may render traditional surgery redundant.
Conclusion:
First‐line use of medical therapy cures most chronic anal fissures cheaply and conveniently. The few non‐responders can be targeted for sphincter assessment before traditional surgery. If the initial good results of new sphincter‐sparing surgery are confirmed, it may be possible to avoid any risk of incontinence, while achieving high rates of fissure healing. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Medical treatment first</description><subject>Anal Canal - surgery</subject><subject>Biological and medical sciences</subject><subject>Botulinum Toxins, Type A</subject><subject>Calcium Channel Blockers</subject><subject>Diltiazem - therapeutic use</subject><subject>Fecal Incontinence - etiology</subject><subject>Fissure in Ano - drug therapy</subject><subject>Fissure in Ano - surgery</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Nitric Oxide Donors - therapeutic use</subject><subject>Nitroglycerin - therapeutic use</subject><subject>Other diseases. Semiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retreatment</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Treatment Failure</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0M1PwkAQBfCN0UhFEw-eDRePxZn97lGLgoaoCRqOm-12NxYLkq5E-e-lAeX0DvPLy-QRco7QRwB6XcxinwuGByRBJkVKUepDkgCASpFR1iEnMc4AkIGgx6SDPMtQUpGQi_y9-VxUrmcXtu6FKsZV40_JUbB19Ge77JK3-7vXfJSOn4cP-c04dUxLTKl1gWeIQWMhQsnBeglWKS-584WDQCljGdXaZyoEV5ZaaekUz6SVWhfAuuRy27tcFXNfmmVTzW2zNn_vbcDVDtjobB0au3BV3DshuELeunTrvqvar_d3MO08ZjOPaecxt4-TNve-il_-59_b5sNIxZQw06ehGUy1YvnLyEzYL-6TYz0</recordid><startdate>200403</startdate><enddate>200403</enddate><creator>Lindsey, I.</creator><creator>Jones, O. M.</creator><creator>Cunningham, C.</creator><creator>Mortensen, N. J. McC</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>200403</creationdate><title>Chronic anal fissure</title><author>Lindsey, I. ; Jones, O. M. ; Cunningham, C. ; Mortensen, N. J. McC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3861-2acf4911f81b5fd40ae60a77e64cebc0f22339288e97ffcdd8786c7496a688b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Anal Canal - surgery</topic><topic>Biological and medical sciences</topic><topic>Botulinum Toxins, Type A</topic><topic>Calcium Channel Blockers</topic><topic>Diltiazem - therapeutic use</topic><topic>Fecal Incontinence - etiology</topic><topic>Fissure in Ano - drug therapy</topic><topic>Fissure in Ano - surgery</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Nitric Oxide Donors - therapeutic use</topic><topic>Nitroglycerin - therapeutic use</topic><topic>Other diseases. Semiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retreatment</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lindsey, I.</creatorcontrib><creatorcontrib>Jones, O. M.</creatorcontrib><creatorcontrib>Cunningham, C.</creatorcontrib><creatorcontrib>Mortensen, N. J. McC</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lindsey, I.</au><au>Jones, O. M.</au><au>Cunningham, C.</au><au>Mortensen, N. J. McC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic anal fissure</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2004-03</date><risdate>2004</risdate><volume>91</volume><issue>3</issue><spage>270</spage><epage>279</epage><pages>270-279</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
The treatment of chronic anal fissure has shifted in recent years from surgical to medical.
Methods:
A Medline search of studies relevant to modern management of chronic anal fissure was undertaken.
Results:
Traditional surgery that permanently weakens the internal sphincter is associated with a risk of incontinence. Medical therapies temporarily relax the internal sphincter and pose no such danger, but their limited efficacy has led to displacement rather than replacement of traditional surgery. Emerging medical therapies promise continued improvement and new sphincter‐sparing surgery may render traditional surgery redundant.
Conclusion:
First‐line use of medical therapy cures most chronic anal fissures cheaply and conveniently. The few non‐responders can be targeted for sphincter assessment before traditional surgery. If the initial good results of new sphincter‐sparing surgery are confirmed, it may be possible to avoid any risk of incontinence, while achieving high rates of fissure healing. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Medical treatment first</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>14991625</pmid><doi>10.1002/bjs.4531</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2004-03, Vol.91 (3), p.270-279 |
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| language | eng |
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| source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Anal Canal - surgery Biological and medical sciences Botulinum Toxins, Type A Calcium Channel Blockers Diltiazem - therapeutic use Fecal Incontinence - etiology Fissure in Ano - drug therapy Fissure in Ano - surgery Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Medical sciences Nitric Oxide Donors - therapeutic use Nitroglycerin - therapeutic use Other diseases. Semiology Postoperative Complications - etiology Retreatment Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Treatment Failure |
| title | Chronic anal fissure |
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