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- Title
The Impact of Fissurectomy Combined with Botulinum Toxin Injection in the Treatment of Chronic Anal Fissure.
- Authors
KARABULUT, Koray; AYGEN, Erhan; KIRKIL, Cüneyt; CAMCI, Cemalettin; DOĞRU, Osman; ESEN, Kazım; BÜLBÜLLER, Nurullah; AYTEN, Refik; İLHAN, Yavuz Selim
- Abstract
Objective: Tile aim of this prospective randomized study was to determine the outcome of fissurectomy combined with botulinum toxin type-A (BTX-A) on the healing of medically resistant fissures over that achieved with BTX-A alone. Materials and Methods: A total of 36 consecutive patients with chronic anal fissure located on posterior midline who failed healing after topical medical therapy were enrolled. The patients were divided into 2 groups. The patients were divided into, BTX and BTX+fissurectomy (FIS) groups. They were clinically checked 1, 2, 4, and 8 weeks after the procedures. Symptomatic relief, early postoperative complications, clinical and anoscopic findings were recorded. The demograpic and clinical parameters were compared using Mann-Whitney U and Chi-squre tests. Results: There were no significant difference between the two groups regarding the age and gender. The most common complaints were rectal bleeding, constipation and pain during and/or after defaecation. All of the procedures performed without any postprocedural complications. Symptoms were reduced significantly with respect to the preoperative value. Symtomatic relief was assesesed in more patients in BTX+FIS group than BTX only group, but the difference was not significant. On 4th week anoscopic examination, complete healing was assesed in 14 (%77.8) and 11 (%61.1) patients in BTX+FIS and BTX groups, respectively. The median follow-up was 5 months. There was no recurrence during the follow-up. None of the patients had continence disturbance. Conclusion: Although BTX-A injection is an effective and safe treatment option in patients with a posterior chronic anal fissure non-responsive to other medical treatments, combining it with fissurectomy does not increase the healing rate.
- Subjects
ANAL diseases; BOTULINUM toxin; THERAPEUTICS; SURGICAL complications; RECTAL surgery; CHI-squared test
- Publication
Firat Tip Dergisi, 2012, Vol 17, Issue 3, p135
- ISSN
1300-9818
- Publication type
Article