Seminars in Colon & Rectal Surgery
Volume 17, Issue 4 , Pages 165-170 , December 2006

A Randomized Controlled Trial Comparing Topical Nitroglycerin to Sphincterotomy in the Treatment of Chronic Anal FissuresLimited Project Grant #059

  • Robin S. McLeod, MD, FRCSC, FACS

      Affiliations

    • Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, and Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
    • Corresponding Author InformationAddress reprint requests to: Dr. Robin S. McLeod, MD, FRCSC, FACS, Room 449, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5.
    • ,
  • Carole Richard, MD, FRCSC

      Affiliations

    • Department of Surgery, University of Montreal.

References 

  1. Richard CS, Gregoire R, Plewes EA, et al. Internal sphincterotomy is superior to topical Nitroglycerin in the treatment of chronic anal fissure (Results of a Randomized, Controlled Trial by the Canadian Colorectal Surgical Trials Group). Dis Colon Rectum. 2000;43:1048–1058
  2. Oh C, Divino CM, Steinhagen RM. Anal fissure: 20-year experience. Dis Colon Rectum. 1995;38:378–382
  3. Pernikoff BJ, Eisenstat TER, Rubin RJ, et al. Reappraisal of partial lateral internal sphincterotomy. Dis Colon Rectum. 1994;37:2191–2195
  4. Lewis TH, Corman MI, Prager ED, et al. Long-term results of open and closed sphincterotomy for anal fissure. Dis Colon Rectum. 1988;31:368–371
  5. Kortbeek JB, Langevin JM, Khoo RE, et al. Chronic fissure-in-ano: a randomized study comparing open and subcutaneous sphincterotomy. Dis Colon Rectum. 1992;35:835–837
  6. Marby M, Alexaner-Williams J, Buchmann P, et al. A randomized controlled trial to compare anal dilatation with lateral subcutaneous sphincterotomy. Ann Surg. 1990;212:235–238
  7. Garcia-Aguilar J, Belmonte C, Wong WD, et al. Open vs. closed sphincterotomy for chronic anal fissure: long-term results. Dis Colon Rectum. 1996;39:440–443
  8. Farouk R, Duthie GS, MacGregor AB, et al. Sustained internal sphincter hypertonia in patients with chronic anal fissure. Dis Colon Rectum. 1994;37:424–429
  9. O’Kelly T, Brading A, Mortensen N. Nerve mediated relaxation of the human internal anal sphincter: the role of nitric oxide. Gut. 1993;34:689–693
  10. Loder PB, Kamm MA, Nicholls RJ, et al. Reversible chemical sphincterotomy by local application of glyceryl trinitrate. Br J Surg. 1994;81:1386–1389
  11. Gorfine SR. Treatment of benign anal disease with topical nitroglycerin. Dis Colon Rectum. 1995;38:453–457
  12. Watson SJ, Kamm MA, Nicholls RJ, et al. Topical glyceryl trinitrate in the treatment of chronic anal fissure. Br J Surg. 1996;83:771–775
  13. Lund JN, Scholefield JH. Glyceryl trinitrate is an effective treatment for anal fissure. Dis Colon Rectum. 1997;40:468–470
  14. Bacher H, Mischinger HJ, Werkgartner G, et al. Local nitroglycerin for treatment of anal fissures: an alternative to lateral sphincterotomy?. Dis Colon Rectum. 1997;40:840–845
  15. Farouk R, Gunn J, Duthie GS. Changing patterns of treatment for chronic anal fissure. Ann R Coll Surg Engl. 1998;80:194–196
  16. Hyman NH, Cataldo PA. Nitroglycerin ointment for anal fissures: effective treatment or just a headache?. Dis Colon Rectum. 1999;42:383–385
  17. Jorge JM, Wexner SD. The etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36:77–97
  18. Nelson R. A systematic review of medical therapy for anal fissure. Dis Colon Rectum. 2004;47:422–431
  19. Khubchandani IT, Reed JF. Sequelae of internal sphincterotomy for chronic anal fissure in ano. Br J Surg. 1989;76:431–434
  20. Brown CJ, Dubreuill D, Santoro L, et al: Lateral internal sphincterotomy is superior to topical nitroglycerin for healing chronic anal fissure and does not compromise long-term fecal continence: 6 year follow up of a multi-center, randomized controlled trial. Dis Colon Rectum (in press)
  21. Rockwood TH, Church JM, Fleshman JW, et al. Fecal incontinence quality of life scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum. 2000;43:9–16
  22. Giebel GD, Lefering R, Troidl H, et al. Prevelance of fecal incontinence: what can be expected?. Int J Colorectal Dis. 1998;13:73–77
  23. Roberts RO, Jacobsen SJ, Reilly WT, et al. Prevalence of combined fecal and urinary incontinence: a community-based study. J Am Geriatr Soc. 1999;47:837–841
  24. Walter S, Hallbook O, Gotthard R, et al. A population-based study on bowel habits in a Swedish community: prevalence of faecal incontinence and constipation. Scand J Gastroenterol. 2002;37:911–916

PII: S1043-1489(06)00088-1

doi: 10.1053/j.scrs.2006.10.004

Seminars in Colon & Rectal Surgery
Volume 17, Issue 4 , Pages 165-170 , December 2006

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