ArticleTechniques in coloproctology2024
Temporal trends and treatment patterns in anal fissure management: insights from a multicenter study in Italy.
Article in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Outcome of lateral internal sphincterotomy for anal fissure in a retrospective cohort of patients.Updates in surgery · 2026Article
- Article
- Therapy and long-term outcomes of acute anal fissure: a high-volume referral centre experience with 623 patients.Techniques in coloproctology · 2026Article
- Non-standardized surgery lateral internal sphincterotomy: Is there a consensus?Turkish journal of surgery · 2025Article
- Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders.Techniques in coloproctology · 2025Article
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Authors and funding
9 authors.
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Abstract
introductionAnal fissure (AF) poses a common challenge in clinical practice, prompting various treatment approaches. This multicenter study, conducted by the Italian Society of Colorectal Surgery, aimed to assess treatment trends in AF over a 10 year period.
methodsA survey of proctologists and retrospective analysis of patient records were conducted to evaluate treatment modalities and outcomes across six different clinical scenarios based on AF presentation (acute/chronic) stratified by sphincter function (normal/hypertonic/hypotonic).
resultsAnalysis of data from 17 principal investigators and 22,016 patients revealed significant variability in treatment approaches, influenced by factors such as symptom duration, anal tone, and surgeon preference. Conservative treatments were commonly utilized, while surgical interventions were reserved for refractory cases. Specifically, pharmaceutical treatment was administered to 66-75% of patients in cases of acute AF and 63-67% for chronic AF, while 10-15% underwent anal dilation, and < 2% received botulinum toxin injection. Among medical treatments, nifedipine with lidocaine and glycerin film-forming ointments were the most utilized. The most performed surgical techniques were fissurectomy and anoplasty, except for patients with chronic AF and hypertonic sphincter where sphincterotomy prevailed. Trends in treatment utilization varied depending on the clinical scenario, with notable shifts observed over time.
conclusionsThis study provides insights into the evolving landscape of AF management, highlighting the need for further research to elucidate optimal treatment strategies and improve patient outcomes.
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