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Topical 0.5% nifedipine vs. lateral internal sphincterotomy for the treatment of chronic anal fissure: long-term follow-up

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to compare the efficacy of the local application of 0.5% nifedipine ointment vs. lateral internal sphincterotomy in the healing of chronic anal fissure.

Patients and methods

Sixty-four patients with symptomatic chronic anal fissures were randomly assigned to 0.5% nifedipine ointment (n=32) every 8 h for 8 weeks or lateral internal sphincterotomy (n=32). Both groups received stool softeners and fiber supplements and were assessed at 2, 4, 6, and 8 weeks. Long-term outcomes were determined after a median follow-up of 19 months (nifedipine group) and 20.5 months (lateral internal sphincterotomy group).

Results

Complete healing at 8 weeks was achieved in 30 out of 31 patients (96.7%) in the nifedipine group and 32 out of 32 patients (100%) in the lateral internal sphincterotomy group (p=0.49). The overall healing rates at the end of follow-up were 28 out of 30 (93%) vs. 32 out of 32 (100%) in the nifedipine and sphincterotomy groups respectively (p=0.48). Two of the 30 patients in the nifedipine group relapsed whereas none in the sphincterotomy group did. Sixteen patients (50%) developed side effects in the nifedipine group, compared with six patients (18.7%) in the sphincterotomy group.

Conclusions

Topical application of 0.5% nifedipine ointment represents a new, promising, easily handled, effective alternative to lateral internal sphincterotomy.

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Authors and Affiliations

  1. Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, 54635, Thessaloniki, Greece

    Panagiotis Katsinelos, George Paroutoglou & Stavros Dimiropoulos

  2. Second Department of Surgery, Central Hospital. Aristoteles University of Thessaloniki, Ethnikis Aminis 41, 54635, Thessaloniki, Greece

    Basilios Papaziogas, Ioannis Koutelidakis, Anastasios Souparis & Konstantinos Atmatzidis

Authors
  1. Panagiotis Katsinelos
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  2. Basilios Papaziogas
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  3. Ioannis Koutelidakis
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  4. George Paroutoglou
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  5. Stavros Dimiropoulos
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  6. Anastasios Souparis
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  7. Konstantinos Atmatzidis
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Correspondence to Panagiotis Katsinelos.

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Katsinelos, P., Papaziogas, B., Koutelidakis, I. et al. Topical 0.5% nifedipine vs. lateral internal sphincterotomy for the treatment of chronic anal fissure: long-term follow-up. Int J Colorectal Dis 21, 179–183 (2006). https://doi.org/10.1007/s00384-005-0766-x

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  • DOI: https://doi.org/10.1007/s00384-005-0766-x

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