Transanal rectal resection can be safely and efficiently performed by means of a SILS port and standard laparoscopic instruments. The rectal defect may be left open and at 1 year continence is not compromised.

This article provides an overview of the principles in the evaluation and management of perianal Crohn's disease (CD). Manifestation-specific treatment is addressed including abscess, fistula, skin tags, hemorrhoids, fissure, ulcers, strictures, ano-, and rectovaginal fistulas as well CD-associated hidradenitis suppurativa.

Topical administration of a phosphodiesterase-5 inhibitor (sildenafil, Viagra) significantly reduces anal sphincter pressure in patients with chronic anal fissure. A beneficial effect of nitric oxide on the spastic anal sphincter has been demonstrated previously. This study confirms that this effect need not be derived solely from nitric oxide donors. New therapeutic avenues for treatment of anal fissure through indirect enhancement of nitric oxide activity are suggested.

No abstract

Controlled intra-anal dosing of topical nitroglycerin produces a significantly greater reduction in sphincteric pressure and lower incidence of headaches than with perianal administration of the same dose of ointment. These results suggest a new paradigm for increasing safety and efficacy of dose-dependent prescription anal topical medications.