Duration of the Sypmtoms Influence the Outcome after Botulinum Toxin Injection in Anal Fissure
Journal Title: Turkish Journal of Colorectal Disease - Year 2019, Vol 29, Issue 1
Abstract
Aim: To assess the effect of duration of the symptoms on outcome after botulinum toxin injection in anal fissure treatment. Method: Data of the patients who underwent botulinum toxin injection for chronic anal fissur were reviewed. Patients with a minimum follow-up of 18 months were included. One-hundred IU botulinum toxine was injected in the internal anal sphincter through 4 quadrants. Follow-up was carried out by clinic visits on post-procedure days 7, 15 and 30 and by telephone survey in 3, 6, 12 and 18th months. Refractory symptoms or recurrence were recorded as failure. The relationship between duration of the symptoms and failure was investigated and a cut-off value was determined. Patients were divided into two groups according to duration of the symtoms and outcome was compared with the patients who underwent lateral internal sphincterotomy within the same period. Results: There were 56 patients fulfilling inclusion criteria. Mean age was 33.1±9.4 and 39 (69.6%) patients were female. Presence of the symptoms longer than 8.5 months was predicting treatment failure (Area under curve: 0.721, confidence interval: 0.500-0.942, p=0.037). There were 38 patients in shorter symptoms group, 18 patients in longer sypmtoms group and 32 patients in lateral internal sphincterotomy group. The compelte healing rates after 21 (18-28) months of median survival were 61.1% in longer symptom botulinum toxin group, 94.7% in shorter symptom botulinum toxin group and 96.2% in lateral internal sphincterotomy group (p=0.003). One patient in botulinum toxin groups had local hematoma and one (3.1%) had minor incontinence in lateral internal sphincterotomy group. Conclusion: Botulinum toxin has similar outcome with lateral internal sphincterotomy in patients with shorter suration of sypmtoms. Proper patient selection may contribute to the success of the treatment in chronic anal fissur.
Authors and Affiliations
Naciye Çiğdem Arslan, Yaşar Özdenkaya
Keywords
Related Articles
- EP ID EP48027
- DOI 10.4274/tjcd.galenos.2018.94547
- Views 277
- Downloads 0
Melanosis Coli: Case Report
Melanosis coli is an incidental benign finding characterized by the deposition of dark brown pigment in the colonic mucosa. The cause of this situation is due to long-term laxative use. We report a female patient who und...
Should Support Group Intervention be Implemented for Individuals with Stoma?
The presence of stoma in individuals causes physical, psychological and social problems. For this reason, individuals with stoma need effective psychosocial interventions in order to adapt to the stoma. One of these effe...
Transanal Advancement Flap Repair: The Current Gold Standard for Cryptoglandular Transsphincteric Perianal Fistulas
Transanal advancement flap repair has been considered as a treatment modality for transsphincteric perianal fistulas for over a century. Several systematic reviews have shown that this technique is effective in 80 percen...
The Use of Negative-pressure Wound Therapy with Instillation Before and After Grafting in the Surgical Management of Hidradenitis Suppurativa
Aim: Hidradenitis suppurativa (HS) is a chronic infection of apocrine sweat glands. HS related morbidities such as chronic infection, and carcinoma development reduce the life quality of the patients. Non-surgical manage...
The Outcome of Combined Electro-fulguration and Surgical Excision Techniques in the Management of Anogenital Condylomas
Aim: Condyloma accuminata (anogenital warts) refers to an epidermal manifestation attributed to human papilloma virus (HPV). It is the most common sexually transmitted disease. In this study, we present our experience wi...