Document Detail

Glyceryl trinitrate ointment (0.25%) and anal cryothermal dilators in the treatment of chronic anal fissures.
MedLine Citation:
PMID:  19367435     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Chronic anal fissure is a common benign disorder; for this condition, lateral internal sphincterotomy is the "gold standard" of treatment. Alternative medical treatments have not proven to be as effective as left lateral internal sphincterotomy. AIM: This randomized trial was designed to compare the use of 0.25% glyceryl trinitrate ointment and anal cryothermal dilators with the use of 0.4% glyceryl trinitrate ointment alone in the treatment of chronic anal fissures. METHODS: Between 1 June 2006 and 31 December 2007, 60 consecutive patients who were suffering from chronic anal fissures were randomized into two groups. The patients in group A (n = 30) were treated with 0.25% glyceryl trinitrate ointment and anal cryothermal dilators twice daily, and those in group B (n = 30) were treated with 0.4% glyceryl trinitrate ointment alone twice daily. The treatment was administered to the patients in each group for 6 weeks, and all patients were examined 7 weeks after the start of the trial. RESULTS: Prior to treatment, the symptoms and the measurements of anal pressure were similar in both groups. At 7 weeks, the maximum resting pressure was significantly lower in group A (P < 0.05), in which 86.6% of the patients were asymptomatic in comparison with 73.3% of the patients in group B. After 1 year of follow-up, 25 patients (83.3%) in group A and 18 patients (60%) in group B presented no recurrence of symptoms (P < 0.05) CONCLUSIONS: Treatment of chronic anal fissures with 0.25% glyceryl trinitrate ointment and anal cryothermal dilators was more effective than the administration of 0.4% glyceryl trinitrate ointment alone.
Michele Schiano di Visconte; Gabriele Munegato
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-04-15
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-09     Completed Date:  2009-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1283-91     Citation Subset:  IM    
General Surgery Department, S. Maria dei Battuti Hospital, Via Brigata Bisagno, 4, 31015, Conegliano (Treviso), Italy.
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MeSH Terms
Administration, Topical
Anal Canal / drug effects*
Chronic Disease
Cryotherapy / instrumentation*
Dilatation / instrumentation*
Fissure in Ano / diagnosis,  therapy*
Follow-Up Studies
Nitroglycerin / therapeutic use*
Pain Measurement
Patient Satisfaction
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Statistics, Nonparametric
Treatment Outcome
Wound Healing / physiology
Young Adult
Reg. No./Substance:
0/Ointments; 55-63-0/Nitroglycerin

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

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