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Miniinvasive Treatment of Chronic Anal Fissure with Intrasfinkteral Injection Type A Botulinum Toxin
- Authors: 1, 2, 2
-
Affiliations:
- Городская поликлиника 150 Департамента здравоохранения города Москвы, Российская Федерация
- Воронежская государственная медицинская академия им. Н.Н.Бурденко, Воронеж, Российская Федерация
- Issue: Vol 6, No 1 (2013)
- Pages: 80-85
- Section: Original articles
- URL: https://vestnik-surgery.com/journal/article/view/108
- DOI: https://doi.org/10.18499/2070-478X-2013-6-1-80-85
- ID: 108
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Abstract
Relevance Anal fissure is one of the most common diseases of the anorectal area. The percentage of anal fissures among the diseases of the colon constitutes 11-15% and the morbidity rate varies from 20 to 23 people per 1000 adults.
The purpose of the study To evaluate the effectiveness of the intra-sphincter injection of botulinum toxin of type A (a drug "Lantoks") in the minimally invasive treatment of the patients with chronic anal fissure.
Materials and methods Results of treatment of 118 patients (67 women and 51 men) with chronic anal fissure were analyzed. Evaluation of the intensity of pain syndrome was performed using a visual analog scale. For functional studies of the closing apparatus of the rectum, a system for perfusion manometry "Polygram" was used before the treatment and on the 21st day after the injection of the drug into the area of the internal anal sphincter.
Results and their discussion According to the data of anorectal profilometry, indicator of both maximal and average pressure in the anal canal at the level of the internal sphincter at rest in patients decreased to normal values. In no case injection of the drug caused anal disease. For the year of observation relapses of chronic anal fissure in patients receiving the drug was not noted. Side effects and complications associated with the use of the drug was also not observed.
Conclusion "Lantoks" is an effective and safe drug for minimally invasive outpatient treatment for patients with chronic anal fissures and minimizes the indications for open surgery.
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About the authors
Городская поликлиника 150 Департамента здравоохранения города Москвы, Российская Федерация
Author for correspondence.
Email: author@vestnik-surgery.com
Postgraduate Student of the epartment of eneral Surgery of the Voronezh State Medical Academy named after .. Burdenko.
Воронежская государственная медицинская академия им. Н.Н.Бурденко, Воронеж, Российская Федерация
Email: surgery-v@yande.ru
M, prof., Head of the epartment of eneral Surgery of the Voronezh State Medical Academy named after .. Burdenko
Воронежская государственная медицинская академия им. Н.Н.Бурденко, Воронеж, Российская Федерация
Email: author@vestnik-surgery.com
M, prof., Head of the epartment of Oncology of the Voronezh State Medical Academy named after .. Burdenko.
References
- Vorob'ev G.I. Osnovy koloproktologii [Fundamentals of coloproctology]. Rostov-na-Donu, Feniks, 2001; 413 p.
- Nothmann B.J., Schuster M.M. Vnutrennego anal'nogo sfinktera s narusheniem anal'nyh treshchin. [Internal anal sphincter derangement with anal fissures]. Gastroenterology, 1974; 67(2): 216–220.
- Novell F., Novell-Costa F., Novell J. Aktual'nost' nitroglicirina v lechenii anal'noj treshchiny. [Topical glyceryl trinitrate in the treatment of anal fissure]. Rev. Esp. Enferm. Dig., 2004, 4(96):255-258.
- Hancock B.D. Vnutrennie sfinktery i anal'nye treshchiny. [The internal sphincter and anal fissure]. Br. J. Surg., 1977; 64(2): 92–95.
- Cho D.Y. Kontroliruemyj bokovoj sfinkterotomii pri hronicheskoj anal'noj treshchine [Controlled lateral sphincterotomy for chronic anal fissure]. Dis. Colon. Rectum., 2005; 5(48): 1037-1041.
- Henry M.M., Swash M. Koloproktologiya i Tazovoe dno. [Coloproctology and the Pelvic Floor]. Edinburgh, London, New York, Oxford, Philadelphia, St. louis, Sydney, Toronto: Sounders, 2002; 494 p.
- Rosa G., Lolli P., Piccinelli D., Mazzola F., Zugni C., Ballarin A., Bonomo S. Otkalibrovka lateral'noj vnutrennej sfinkterotomii pri hronicheskoj anal'noj treshchine. [Calibrated lateral internal sphincterotomy for chronic anal fissure]. Tech. Coloproctol., 2005; 2(9): 127131.
- Nelson R. Meta-analiz operativnyh tekhnik dlya treshchin-v-ano. [Meta-analisis of operative Techniques for Fissure-In-ano]. Dis. Colon. Rectum., 1999; 11(42): 1424143.
- Garcia-aguilar J, Belmonte C, Wong W.D., Lowry A.C., Madoff R.D. Otkrytaya i zakrytaya sfinkterotomiya pri hronicheskih anal'nyh treshchinah: dolgosrochnye rezul'taty. [Open vs. closed sphincterotomy for chronic anal fissure: long term results]. Dis. Colon Rectum, 1996; 39: 440-443.
- Khubchandani I.T., Reedand J. F. Oslozhneniya vnutrennej sfinkterotomii pri hronicheskoj treshchine v ano. [Sequelae of internal sphincterotomy for chronic fissure in ano]. Br. J. Surg., 1989; 5(76): 431-434.
- Jost W.H., Schimrigk K. Primenenie botulinicheskogo toksina v anal'noj treshchine. [Use of botulinum toxin in anal fissure]. Dis. Colon Rectum, 1993; 36(10): 974.
- Jost W.H. Sto sluchaev, gde anal'nye treshchiny lechatsya s botulotoksinom: rannie i otdalennye rezul'taty. [One hundred cases of anal fissure treated with botulin toxin: early and long-term results]. Dis. Colon Rectum, 1997 Sep; 40(9): 1029-32.
- Lindsey I., Cunningham C., Jones O.M. Intrasfinkternoe vvedenie botulinicheskogo toksina. [Fissurectomybotulinum toxin: a novel sphincter-sparing procedure for medically resistant chronic anal fissure]. Dis. Colon Rectum, 2004; 11(47): 1947-1952.
- Brisinda G., Albanese A., Cadeddu F., Bentivoglio A.R., Mabisombi A., Marniga G., Maria G. Botulinicheskij nejrotoksin dlya lecheniya hronicheskoj anal'noj treshchiny: rezul'taty randomizirovannogo "botox vs. dysport" kontroliruemoe issledovanie. [Botulinum neurotoxin to treat chronic anal fissure: results of a randomized "botox vs. dysport" controlled trial]. Aliment. Pharmacol. Ther. 2004 Mar 15; 19(6): 695-701.
- Brisinda G, Cadeddu F, Brandara F, Marniga G, Vanella S, Nigro C, Maria G. Botulotoksin recidivy anal'noj treshchiny posle lateral'noj vnutrennej sfinkterotomii. [Botulinum toxin for recurrent anal fissure following lateral internal sphincterotomy]. Br. J. Surg., 2008 Jun; 95(6): 774-778.
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