Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy
被引:19
作者:
Pascual, Marta
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Pascual, Marta
Pera, Miguel
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Pera, Miguel
Courtier, Ricard
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Courtier, Ricard
Gil, Maria Jose
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Gil, Maria Jose
Pares, David
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Pares, David
Puig, Sonia
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Puig, Sonia
Andreu, Montserrat
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Andreu, Montserrat
Grande, Luis
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机构:Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
Grande, Luis
机构:
[1] Hosp Mar, Colorectal Surg Unit, Dept Surg, Barcelona 08003, Spain
[2] Hosp Mar, Dept Gastroenterol, Barcelona 08003, Spain
Background and aims Anorectal pressure studies have demonstrated internal anal sphincter (IAS) hypertonia in patients with chronic anal fissure. It is unknown however, if these changes in IAS function are associated with any abnormality in sphincter morphology. The first aim was to investigate the clinical characteristics and the manometric and endosonographic findings of the IAS in a cohort of patients with chronic anal fissure. The second aim was to investigate the association between these findings and the outcome with topical Glyceryl trinitrate (GTN) therapy. Materials and methtods All patients who presented with chronic anal fissure from November 1999 to May 2004 were included after failure of conservative therapy. Anorectal manometry and anal endosonography were performed before treatment with 0.2% GTN ointment twice daily was initiated. Patients were evaluated after 8 weeks. Results One hundred and twenty-four patients (66 women, mean age, 45.2 +/- 14.8 years) were included. Hypertonia of the IAS was found in 84 (68%) patients. The mean maximum IAS thickness was 3.6 +/- 0.76 mm (1.6-5.5). An abnormally thick IAS, adjusted by age, was observed in 113 (91.1%) patients. We found no correlation between resting pressure and IAS thickness (r = 0.074; p = 0.41). At 8 weeks, 52 patients (42%) had healed with complete symptoms resolution. No statistically significant differences were observed when clinical features and manometric and endosonographic findings were compared between healing and no-healing fissures. Conclusions The majority of patients with chronic anal fissure present an abnormally thick IAS. Clinical, manometric and endosonographic features had no association with outcome after GTN treatment.
机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Bove A.
Balzano A.
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Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Balzano A.
Perrotti P.
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Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Perrotti P.
Antropoli C.
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Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Antropoli C.
Lombardi G.
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Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Lombardi G.
Pucciani F.
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机构:
Coloproctology Unit, Department of Surgery, Careggi Hospital, FlorenceColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
机构:
MCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADAMCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADA
Hananel, N
Gordon, PH
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MCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADAMCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADA
机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Bove A.
Balzano A.
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h-index: 0
机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Balzano A.
Perrotti P.
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h-index: 0
机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Perrotti P.
Antropoli C.
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h-index: 0
机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Antropoli C.
Lombardi G.
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机构:
Coloptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 NaplesColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
Lombardi G.
Pucciani F.
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h-index: 0
机构:
Coloproctology Unit, Department of Surgery, Careggi Hospital, FlorenceColoptroctology Unit, Department of Gastroenterology, Cardarelli Hospital, I-80131 Naples
机构:
MCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADAMCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADA
Hananel, N
Gordon, PH
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h-index: 0
机构:
MCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADAMCGILL UNIV,SIR MORTIMER B DAVIS JEWISH HOSP,DEPT SURG,MONTREAL,PQ H3T 1E2,CANADA