Resultados de la encuesta nacional sobre el tratamiento de la fisura anal crónica en los hospitales españoles / Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals

Introducción: El tratamiento de la fisura anal crónica (FAC) difiere en función del profesional. Para plantear un consenso, sería conveniente conocer el estado actual a nivel nacional. El objetivo del presente estudio es conocer la situación actual del manejo de la FAC en los hospitales españoles. Métodos: Estudio descriptivo, con datos de encuestas a cirujanos de la Asociación Española de Coloproctología en las que se han recogido datos de la comunidad autónoma, tipo de hospital y categoría profesional, opinión sobre el manejo de la FAC en general y relativa a 3 casos clínicos específicos. Resultados: Se ha recibido respuesta de 152 cirujanos. Las medidas farmacológicas constituyen el primer escalón terapéutico (93,38%). En paciente con hipertonía y sin factores de riesgo de incontinencia fecal (IF), el 55,9% emplea medidas higiénico-dietéticas asociadas a pomada de nitroglicerina (MHG + NTG). El segundo escalón lo constituiría la esfinterotomía lateral interna (ELI) (43,4%). En paciente con factores de riesgo de IF, se utiliza MHG + NTG (75,7%) y en caso de fracaso, ELI previa ecografía y/o manometría. En paciente joven con hipertonía inexplorable y proctalgia incapacitante sin factores de riesgo de IF, se trataría con MHG + NTG (55,9%) y si fracasa, ELI (46,1%). Conclusiones: El manejo de la FAC en España presenta similitudes con las recomendaciones que realizan las guías internacionales. Sin embargo, se observan algunas diferencias incluso desde las primeras opciones de tratamiento (AU)

Introduction: The treatment of chronic anal fissure (FAC) differs depending on the professional. To come to a consensus, the current situation in Spain should be studied. The aim of this study is to evaluate the current situation of the management of FAC in Spanish hospitals. Methods: Descriptive study, with data from a survey of surgeons of the Spanish Association of Coloproctology. Data was collected according to the doctor's autonomous community, type of hospital and professional category; FAC management data and 3 clinical cases. Results: Response was obtained from 152 surgeons. Pharmacological measures stand out as the first therapeutic step (93.38%). In patients with hypertonia and with no risk factors for fecal incontinence (FI), 55.9% use hygienic-dietary measures associated with nitroglycerin ointment (MHG + NTG). The second step is internal lateral sphincterotomy (ELI) (43.4%). MHG + NTG (75.7%) is used in patients with FI risk factors and in case of failure, ELI is used with a prior ultrasound and/or manometry. In young patients with unexplained hypertonia and incapacitating proctalgia with no risk factors for FI, MHG + NTG (55.9%) is used and, if it is not successful, they are treated with ELI (46.1%). Conclusions: The management of FAC in Spain shows similarities with the international guideline suggestions. Nevertheless, some differences can be seen from the first stages of treatment (AU)

Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. / Resultados de la encuesta nacional sobre el tratamiento de la fisura anal crónica en los hospitales españoles.

INTRODUCTION: The treatment of chronic anal fissure (FAC) differs depending on the professional. To come to a consensus, the current situation in Spain should be studied. The aim of this study is to evaluate the current situation of the management of FAC in Spanish hospitals. METHODS: Descriptive study, with data from a survey of surgeons of the Spanish Association of Coloproctology. Data was collected according to the doctor's autonomous community, type of hospital and professional category; FAC management data and 3 clinical cases. RESULTS: Response was obtained from 152 surgeons. Pharmacological measures stand out as the first therapeutic step (93.38%). In patients with hypertonia and with no risk factors for fecal incontinence (FI), 55.9% use hygienic-dietary measures associated with nitroglycerin ointment (MHG+NTG). The second step is internal lateral sphincterotomy (ELI) (43.4%). MHG+NTG (75.7%) is used in patients with FI risk factors and in case of failure, ELI is used with a prior ultrasound and/or manometry. In young patients with unexplained hypertonia and incapacitating proctalgia with no risk factors for FI, MHG+NTG (55.9%) is used and, if it is not successful, they are treated with ELI (46.1%). CONCLUSIONS: The management of FAC in Spain shows similarities with the international guideline suggestions. Nevertheless, some differences can be seen from the first stages of treatment.