Sphincter-sparing treatment of anal fissure

Bashankaev B.N.; Glabay V.P.; Di-Franco I.V.; Arkharov A.V.; Ivanov V.V.

doi:https://doi.org/10.17116/hirurgia201808273

Bashankaev B.N.

European Medical Centre. Moscow, Russia

ORCID: 0000-0003-2397-6578

Glabay V.P.

Chair of Surgery of Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia, City Clinical Hospital No. 3, Moscow, Russia

Di-Franco I.V.

GMS clinicand hospitals, Moscow,Russia

Arkharov A.V.

Chair of Surgery of Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia, City Clinical Hospital No. 3, Moscow, Russia

Ivanov V.V.

N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russia, Moscow, Russia

Sphincter-sparing treatment of anal fissure

Authors:

Bashankaev B.N., Glabay V.P., Di-Franco I.V., Arkharov A.V., Ivanov V.V.

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Journal: Pirogov Russian Journal of Surgery. 2018;(8): 73‑77

DOI: 10.17116/hirurgia201808273

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To cite this article:

Bashankaev BN, Glabay VP, Di-Franco IV, Arkharov AV, Ivanov VV. Sphincter-sparing treatment of anal fissure. Pirogov Russian Journal of Surgery. 2018;(8):73‑77. (In Russ.)
https://doi.org/10.17116/hirurgia201808273

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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Abstract:

Surgical treatment of the anal fissure is associated with unreasonably high risks of delayed development of fecal incontinence to gas or liquid stool. Standardized sphincter-preserving therapy, based on the pharmacological reduction of increased internal anal sphincter tone (chemical sphincterotomy) allows to improve significantly the results of the non-surgical approach of treating one of the most common pathology in proctological practice. Our work presents a retrospective analysis of the treatment of 295 patients with anal fissure treated with diltiazem ointment, nifedipine ointment, nitroglycerin ointment and botulinum toxin A. Significant improvement or disappearance of complaints was noted in 84% of patients. The use of botulinum toxin A was successfull in 10 out of 11 patients without the need of surgical intervention. High efficiency (91% of patients) of the sphincter-preserving approach with a significant decrease in the need for aggressive surgical manipulation allows to decrease sphincterotomy rate and reduces the risk of delayed fecal incontinence.

Keywords:

anal fissure

sphincter-sparing treatment

Authors:

Bashankaev B.N.

European Medical Centre. Moscow, Russia

ORCID: 0000-0003-2397-6578

Glabay V.P.

Chair of Surgery of Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia, City Clinical Hospital No. 3, Moscow, Russia

Di-Franco I.V.

GMS clinicand hospitals, Moscow,Russia

Arkharov A.V.

Chair of Surgery of Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia, City Clinical Hospital No. 3, Moscow, Russia

Ivanov V.V.

N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russia, Moscow, Russia

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