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Colegio de Medicos y Cirujanos República de Costa Rica

2015, Number 615

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Rev Med Cos Cen 2015; 72 (615)

Manejo de la fisura anal

Soto DM

Language: Spanish
References: 10
Page: 343-345
PDF size: 142.70 Kb.


ABSTRACT

Anal fissure is a frequent cause of consult in proctology. Its main symptom is pain, and bleeding may be present. Its pathophysiology is due to several factors such as: trauma, spasm of the sphincter and ischemia. Treatment aims to address these factors. Surgical treatment (fissurectomy or sphincterotomy) is considered the most effective treatment. However surgical management carries some risk of fecal incontinence, reason why in recent years the research has been intensified towards medical measures such as topical nitroglycerin, calcium channel blockers and botulinum toxin.


REFERENCES

  1. Brisinda, G., Maria, G., Bentivoglio, A. R., Cassetta, E., Gui, D., & Albanese, A. (1999). A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. New England Journal of Medicine, 341(2), 65-69.

  2. Giorgio, M., Casseta, E., Gui, D., Brisinda, G., Bentivoglio, A. R., & Albanese, A. (1998). A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. New England Journal of Medicine, 338(4), 217-220.

  3. Higuero T. Update on the management of anal fissure. Journal of Visceral Surgery (2014), http://dx.doi. org/10.1016/j.viscsurg.2014.07.007

  4. Lund, J. N., & Scholefield, J. H. (1996). Aetiology and treatment of anal fissure. British journal of surgery, 83(10), 1335-1344.

  5. Madalinski, M. H. (2011). Identifying the best therapy for chronic anal fissure. World journal of gastrointestinal pharmacology and therapeutics, 2(2),9.

  6. Nelson RL, Chattopadhyay A, Brooks W, Platt I, Paavana T, Earl S. Operative procedures for fissure in ano. Cochrane Database of Systematic Reviews 2011, Issue 11. Art. No.:CD002199. DOI:10.1002/14651858.CD002199. pub4.

  7. Nelson, R. (2010). Anal fissure (chronic). Clinical evidence, 2010.

  8. Nelson R. Tratamiento no quirúrgico para la fisura anal (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2008 Número 4. Oxford: Update Software Ltd. Disponible en: http://www.update-software.com. (Traducida de The Cochrane Library, 2008 Issue 3. Chichester, UK: John Wiley & Sons, Ltd.).

  9. Perry, W. B., Dykes, S. L., Buie, WD., Rafferty, J. F., & Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. (2010). Practice parameters for the management of anal fissures (3rd revision). Diseases of the Colon & Rectum, 53(8), 1110-1115.

  10. Zaghiyan, K. N., & Fleshner, P. (2011). Anal fissure. Clinics in colon and rectal surgery, 24(1), 22.




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