Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
9394506 | Cirugía Española | 2005 | 7 Pages |
Abstract
We recommend surgical sphincterotomy (preferably open or closed lateral sphincterotomy) as the first therapeutic approach in patients with chronic anal fissure. However, we prefer the use of chemical sphincterotomy (preferably botulinum toxin) in patients aged more than 50 years old and in those with previous incontinence, risk factors for incontinence (previous anal surgery, multiple vaginal births, diabetes, inflammatory bowel disease, etc.), or without anal hypertonia, despite the higher recurrence rate with medical treatments, since this procedure avoids the greater risk of residual incontinence described in the literature with surgical sphincterotomy in this group of patients.
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Authors
Antonio Arroyo, Francisco Pérez-Vicente, Pilar Serrano, Fernando Candela, Ana Sánchez, MarÃa Teresa Pérez-Vázquez, Rafael Calpena,