Duration of the Sypmtoms Influence the Outcome after Botulinum Toxin Injection in Anal Fissure
Journal Title: Türk Kolon ve Rektum Hastalıkları Dergisi - 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 EP533764
- DOI 10.4274/tjcd.galenos.2018.94547
- Views 95
- Downloads 0
Application of Elective Surgery with Vacuum Assisted Treatment in Traumatic Rectum Injury
The most important factor in the diagnosis of rectal injuries is suspicion. Rectal injury should be considered in penetrating trauma affecting the perineum, upper thighs, gluteal regions, and lower abdomen. With vacuum-a...
Coexisting Primary Malignant Lymphoma and Adenocarcinoma of the Intestinal Tract
.
Idiopathic Nonobstructive Colo-colonic Intussusception: A Rare Clinical Presentation
Adult intussusception is a rare clinical condition. There is generally an etiological factor, mainly malignancy. However, the number of idiopathic cases is very low. Patients may present with obstruction or acute abdomen...
Polypropylene Manual Knotting for Closure of Appendix Stump During Laparoscopic Appendectomy
Aim: To evaluate the results of patients in whom the appendix stump was closed with a hand-made loop using polypropylene suture during laparoscopic appendectomy. Method: The files of 25 patients who underwent laparoscop...
Synchronous Appendiceal Neoplasia of Ascending Colon Cancers: Three Case Reports And Review of the Literature
Colorectal carcinomas are the most common malignancies of the gastrointestinal tract. The incidence of synchronous primary appendicular neoplasms associated with colorectal cancer has been reported as 0.3-4.1%, but most...