Innovations in chronic anal fissure treatment:A systematic review

作     者：Aaron Poh Kok-Yang Tan Francis Seow-Choen 

作者机构：Department of SurgeryKhoo Teck Puat HospitalSingapore 768828Singapore Seow-Choen Colorectal CentreSingapore 228510Singapore 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2010年第2卷第7期

页      面：231-241页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Anal fissure Innovative therapy Glyceryl trinitrate Lateral sphincterotomy Diltiazem Botulinum toxin Perineal support device 

摘      要：A chronic anal fissure is a common perianal *** review aims to evaluate both existing and new therapies in the treatment of chronic *** therapies such as glyceryl trinitrate(GTN),Diltiazem ointment and Botulinum toxin provide a relatively non-invasive option,but with higher recurrence *** sphincterotomy remains the gold standard for *** dilatation has no role in *** therapies include perineal support devices,Gonyautoxin injection,fissurectomy,fissurotomy,sphincterolysis,and flap *** research is required comparing these new therapies with existing established *** paper recommends initial pharmacological therapy with GTN or Diltiazem ointment with Botulinum toxin as a possible second line pharmacological *** support may offer a new dimension in improving healing *** sphincterotomy should be offered if pharmacological therapy *** therapies are not suitable as first line treatments,though they can be considered if conventional treatment fails.