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Frequency of complications in Dysport injection and Lateral internal Sphincterotomy in patients with anal fissure in Be’sat hospital (2003
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S Heidari   , N Vaseiy , S Zareiy |
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Abstract: (15599 Views) |
Introduction: Although lateral internal sphincterotomy is the procedure
of choice for chronic anal fissures it is associated with significant
complications. Injection of Botulinum toxin in the internal sphincter
is a new treatment option with fewer side effects. This paper tries to
compare these two approaches in terms of complications.
Materials and methods: In this cross sectional study, 50 patients with anal
fissure who underwent lateral internal sphincterotomy in 1382 and
50 patients who were treated with Botulinum toxin, were evaluated.
20mg IV of Dysport was injected into the internal anal sphinter.
Injection was repeated two weeks later if complete healing was not
accomplished. Then the patients’ complications were evaluated
within 12 months.
Results: In the sphincterotomy group the success rate was 84
percent(42/50) at 2 weeks and 94 percent(47/50) at the first month.
Incontinence to flatus occurred in 16 percent and mild soiling was
reported in 2 percent.
Fistula occurred in 6 percent, and recurrence occurred in 8 patients.
In the Botulinum Toxin group, single injection resulted in complete
healing in 38 patients (76%). 12 patients were treated with a second
injection, which resulted in an overall 90 percent Of healing. There
were no complications and recurrence occurred in 11 patients.
Conclusion: Injection of botulinum toxin is safe and effective in the
treatment of anal fissure. No adverse effect resulted from injections
of the toxin.
We suggest two injections of Botulinum toxin as the first step in
treatment of anal fissure. The patients who were not treated by
injection of Botulinum toxin or had recurrence, underwent lateral
Internal sphincterotomy. |
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| Keywords: Dysport injection, Lateral internal Sphincterotomy, Anal fissure |
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Full-Text [PDF 244 kb]
(2035 Downloads)
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Type of Study: Original |
Received: 2012/03/7 | Accepted: 2014/06/3 | Published: 2014/06/3
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