Document Detail

Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective, randomized study.
MedLine Citation:
PMID:  19361582     Owner:  NLM     Status:  MEDLINE    
AIM: The results of controlled-intermittent anal dilatation (CIAD) or lateral internal sphincterotomy (LIS) in the treatment of chronic anal fissures are presented. MATERIAL AND METHODS: Forty patients who were randomized to two groups underwent CIAD or a LIS. The pre- and post-operative mean anal canal resting pressures (MACRPs) and symptoms were recorded and the results were compared. RESULTS: Two months post-operatively, 18 patients in the CIAD group and 17 patients in the LIS group had healed completely, and had no anal incontinence or other complications. The post-operative improvement in pain, bleeding, and constipation did not differ significantly between the two groups. In the CIAD and LIS groups, the pre-operative MACRPs were 89.7+/-16.5 and 87.6+/-12.3 mmHg, respectively; 2 months post-operatively, the MACRPs had significantly decreased to 76.9+/-13.7 and 78.1+/-11.3 mmHg in the CIAD and LIS groups, respectively. No statistical difference existed in the pre- or post-treatment MACRPs between the groups. CONCLUSION: CIAD applied with a standardized technique reduced anal canal resting pressure and provided symptomatic healing that was equivalent to a LIS. Since there were no findings of incontinence, or situations which resulted in sphincter damage, we conclude that CIAD is suitable for patients with chronic anal fissures because it is less invasive than LIS, with equivalent efficacy and safety. In addition, the CIAD method may be an alternative procedure in older and multiparous women who has a higher risk of incontinence.
Tayfun Yucel; Dogan Gonullu; Mahmut Oncu; Ferda Nihat Koksoy; Sibel Gurdal Ozkan; Omer Aycan
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-04-08
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  7     ISSN:  1743-9159     ISO Abbreviation:  -     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  228-31     Citation Subset:  IM    
Sakarya University, Sakarya Medical School, Department of Surgery, Sakarya, Turkey.
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MeSH Terms
Anal Canal / surgery*
Balloon Dilatation / methods*
Chi-Square Distribution
Chronic Disease
Digestive System Surgical Procedures*
Double-Blind Method
Fissure in Ano / therapy*
Middle Aged
Postoperative Complications
Prospective Studies
Statistics, Nonparametric
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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