The treatment of anal fissure by lateral subcutaneous internal sphincterotomy—A technique and results

Notaras, M J

doi:10.1002/bjs.1800580204

Cited by 160 publications

(46 citation statements)

References 7 publications

(4 reference statements)

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“…Lateral internal sphincterotomy (LIS) has been found to be the preferred operation. LIS can be performed using either the open or closed technique , the method of Notaras, dividing the IAS via a small stab wound (Notaras, 1971). Equal success has been reported with open or closed lateral sphincterotomy for acute and chronic anal fissures in children.…”

Section: Internal Anal Sphincterotomymentioning

confidence: 99%

Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature

Klin¹,

Abu-Kishk²,

Efrati³

et al. 2012

Complementary Pediatrics

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Section: Internal Anal Sphincterotomymentioning

confidence: 99%

Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature

Klin¹,

Abu-Kishk²,

Efrati³

et al. 2012

Complementary Pediatrics

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“…This complete healing rate was lower than that reported previously with 0.2% glyceryl trinitrate (GTN; 59%-70%). 14,15 However, there were no disabling side effects that are observed with GTN and result insignificant treatment failure. Fissure healing was complete in 58% of patients receiving topical diltiazem.…”

Section: Discussionmentioning

confidence: 97%

“…In comparison, time taken has been reported to be 2-3 weeks with lateral sphincterotomy, 4-7 weeks with posterior sphincterotomy, and 2-3 months with topical GTN applications. 14,15 In a prospective, randomized, double-blind study, conducted by Rajakannu M et al, 90 patients with AF were recruited. Patients received local applications of ointments containing 5% lignocaine (N=28), 0.5% minoxidil (N=36), or both (N=26) (78).…”

Section: Discussionmentioning

confidence: 99%

Comparison of topical agents minoxidil and diltiazem in medical management of anal fissures: a hospital based study

et al. 2017

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Background: Anal fissures are associated with spasm of the internal anal sphincter and pain. In present study we compared the efficacy of local application of 0.5% minoxidil and 2% diltiazem in symptomatic relief and healing of anal fissures.Methods: In this prospective, randomized, double blind study, a total of 100 patients with anal fissure were recruited, (50 patients in each group). Patients in group A received local applications of ointments containing 0.5% minoxidil, while patients in group B received topical 2% Diltiazem. Healing of anal fissure and symptomatic relief were observed and analyzed.Results: Rates of complete healing of fissure were similar in the two groups (minoxidil 27/50, diltiazem 29/50). Mean (SD) time taken for complete healing was significantly shorter with minoxidil (3.1 weeks as compared to diltiazem (4 weeks). Rates of pain relief were similar in the two groups. Stoppage of bleeding occurred more often with use of minoxidil than with diltiazem. No patient had systemic or local side effects.Conclusions: Treatment with minoxidil helps in faster healing of anal fissures and provides similar symptomatic relief as that of diltiazem.

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“…However, from approximately 24 years ago, some authorities believed that the aim of any operation is a successful cure with minimal discomfort and disability to the patient. 7 The issue of which technique of anesthesia is best for pain relief has remained a question. It is generally accepted that today the majority of minor anorectal diseases such as chronic anal fissure are performed on an ambulatory basis.…”

Section: Discussionmentioning

confidence: 99%

Lateral internal sphincterotomy under local anesthesia (randomized clinical trial)

et al. 2006

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Background: Nowadays there is an attempt to perform lateral internal sphincterotomy (LIS) operation on an ambulatory basis under local anesthesia. This study aimed to compare postoperative outcome in local anesthesia with spinal anesthesia.Methods: A randomized, double blinded, controlled trial was performed on 62 patients divided into group A (Local Anesthesia) and Group B (Spinal Anesthesia) with n=31 equally. To achieve adequate anesthesia a cocktail, 6 cc of Lidocaine 2% and Marcaine 0.5% with the addition of some bicarbonate was injected into subcutaneous tissue and 20 cc of this was injected into the intersphincteric space before LIS. Postoperative pain was assessed by a 10 cm VAS.Results: Needle pain scores in group A and B were: 2.29±1.40 vs. 16.1±0.88 but pain scores, 6 hours after LIS, before leaving hospital and at the first week after the operation were significantly lower in group A than B (1.90±1.07 vs. 3.77±1.25, 0.90±0.47 vs. 1.65±0.75, 0.71±0.46 vs.1.06±0.51 respectively). Need of opioid and codeine in the first 24 hours after the operation in group A was significantly less than the other group. Also nausea and vomiting in group A was significantly lower than group B.Conclusion: The study showed that LIS under local anesthesia is a less painful technique in office surgery.

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The treatment of anal fissure by lateral subcutaneous internal sphincterotomy—A technique and results

Cited by 160 publications

References 7 publications

Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature

Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature

Comparison of topical agents minoxidil and diltiazem in medical management of anal fissures: a hospital based study

Lateral internal sphincterotomy under local anesthesia (randomized clinical trial)

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