SciELO - Scientific Electronic Library Online

vol.47 número4Fibrolamellar hepatocellular carcinoma at a tertiary centre in South Africa: A case seriesTuberculous anal fistulas - prevalence and clinical features in an endemic area índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados



Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google


South African Journal of Surgery

versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361


ABD ELHADY, H. M. et al. Long-term prospective randomised clinical and manometric comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure. S. Afr. j. surg. [online]. 2009, vol.47, n.4, pp.112-115. ISSN 2078-5151.

AIM: To compare surgical and chemical sphincterotomy for treatment of chronic anal fissure. METHODS: The 160 patients studied were randomly divided into four equal groups, treated by lateral internal sphincterotomy (group S), local diltiazem ointment (group D), local glyceryl trinitrate ointment (group GTN), or injection of botulinum toxin into the internal anal sphincter (group BT). Anal manometry was performed before and 3 months after treatment. Patients were followed up for 5 years. RESULTS: Complete pain relief was achieved in means (± standard deviation) of 5.7±7.8 days (group S), 15.7±5.9 days (group D), 15.6±5.9 days (group GTN) and 2.7±3.6 days (group BT). The mean times to healing were 4.5±1.2 weeks (group I), 5.1±1.1 weeks (group D), 5.0±1.1 weeks (group GTN) and 5.1±1.3 weeks (group BT). Mean resting and squeeze anal pressures decreased significantly after sphincterotomy. Recurrence rates were 10% in group S, 65% in group D, 57.5% in group GTN and 52.5% in group BT. CONCLUSION: Lateral internal sphincterotomy is an easy procedure with satisfactory results, minimal complications and a low recurrence rate. Medical sphincterotomy is safe and easy, with mild complications. Its effect is reversible, and relapse is common. We recommend that medical sphincterotomy be tried before surgery or in patients who are unable or unwilling to undergo surgery.

        · texto en Inglés     · Inglés ( pdf )


Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons