[ comparison between results of topical nitroglycerin ointment and sphincterotomy in chronic idiopathic anal fissure]

ABSTRACT

Chronic anal fissure is a common problem, and there are different ways for treatment. The goal of this study was to compare the effectiveness and complications of topical nitroglycerin with internal sphicterotomy in the treatment of chronic anal fissure. This randomized clinical trial study was performed from 2002 to 2005 at Imam Reza Hospital, Mashhad, Iran on 200 patients with symptomatic anal fissure, who randomly categorized into two groups of case [n=100] and control [n=100]. The case group [A] treated with nitroglycerin ointment%0.2 twice a day for 6 weeks and the control group [B] recieved sphincterotomy. Individual, surgical and medical results data were recorded in the questionnaire. Data analyzed using descriptive statistics, frequency distribution tables, and Fisher test. after 6 weeks of treatment, results showed that healing was not significantly different between the two groups, but after 6 months, difference was significant [p=0/11]. Surgical group healed 100%. Headache in medical group was more noticable than the other group [p<0/001]. But hypotension attack, palpitation, dizziness, and vomiting were not considerably different between the two groups. Internal sphincterotomy is superior to topical nitroglycerin in treatment of chronic anal fissure, with a high rate of healing, few side effects, and low risk of early incontinence