Franz Raulf

Analfissur


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M, Alexander-Williams J, Buchmann P et al.: A randomized controlled trial to compare anal dilatation with lateral subcutaneous sphincterotomy for anal fissure. Dis Colon Rectum 22, 308–311, 1979

      Mazier WP: An evaluation of the surgical treatment of anal fissure. Dis Colon Rectum 15, 222–227, 1972

      Mentes BB, Irkörücü O, Akin M et al.: Comparison of botulinum toxin injection and lateral sphincterotomy for the treatment of chronic anal fissure. Dis Colon Rectum 46, 232–237, 2003

      Pascual M, Pera M, Courtier R et al.: Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topic glyceryl trinitrate. Int J Coloproctol Dis 22, 963–967, 2007

      Pernikoff BJ, Eisenstat TE, Rubin RJ et al.: Reappraisal of partial lateral internal sphincterotomy. Dis Colon Rectum 37, 1291–1295, 1994

      Prohm P: Analyse der prä- und postoperativen Kontinenzfunktion nach lateraler Sphinkterotomie am Beispiel der chronischen Analfissur. Kontinenz 2, 120–124, 1993

      Richard CS, Gregoire R, Plewes EA et al.: Internal sphincterotomy is superior to topical nitroglycerin in the treatment of chronic anal fissure. Dis Colon Rectum 43, 1048–1057, 2000

      Stürmlinger M: Funktionelle Ergebnisse der lateralen Sphinkterotomie im Rahmen der Behandlung der chronischen Analfissur. Med. Diss. Düsseldorf, 1986

      Vafai M, Mann CV: Ambulante geschlossene laterale interne Sphinkterotomie in der Behandlung von Analfissuren. coloproctology 9, 49–53, 1987

      Wolff J: Die Analfissur und ihre chirurgische Therapie: eine Nachuntersuchung des Patientengutes der Chirurgischen Universitätsklinik Bonn-Venusberg von 1979–1984. Med. Diss. Bonn, 1986

       3.5. Krankheitsdauer

      Analfissurpatienten sind offenbar sehr duldsam, denn sie ertragen ihre Schmerzen erstaunlich lange, bevor sie sich in Behandlung begeben. In mehreren Studien wurde die Zeitdauer bis zum Therapiebeginn recherchiert. Bei 491 Patienten in acht Studien, die mit Glyceryltrinitrat (GTN) behandelt wurden, betrug diese Leidenszeit 2 bis 240 Monate, in sieben Botulinumtoxin-Studien (BTX) mit 405 Patienten 3 bis 94 Monate. Bei 842 Patienten (in neun Studien), die sich einer Sphinkterotomie unterzogen, bestanden die Symptome über eine Dauer von 1 bis 96 Monaten. Im Durchschnitt betrug die Anamnesedauer mehr als zehn Monate.

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      Tab. 5 Dauer der Beschwerden bis zur GTN-Therapie

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      Tab. 6 Dauer der Beschwerden bis zur BTX-Therapie

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      Tab. 7 Dauer der Beschwerden bis zur Sphinkterotomie

      LITERATUR

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      Brown CJ, Dubreuil D, Santoro L et al.: Lateral internal sphincterotomy is superior to topical nitroglycerin for healing chronic anal fissure and does not compromise long-term fecal continence: six-year follow-up of a multicenter, randomized, controlled trial. Dis Colon Rectum 50, 447–448, 2007

      Colak T, Ipek t, Urkaya N et al.: A randomised study comparing systemic transdermal treatment and local application of glyceryl trinitrate ointment in the management of chronic fissure. Engl J Surg Suppl 588, 18–22, 2003

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      Lund JN, Scholefield JH: A randomized, prospective, double-blind placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure. Lancet 349, 11–14, 1997

      Maria G, Brisinda G, Bentivoglio AR et al.: Botulinum toxin injections in the internal anal sphincter for the treatment of chronic anal fissure: long-term results after two different dosage regimens. Ann Surg 228, 664–669, 1998

      Maria G, Cassetta E, Gui D et al.: A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. N Engl J Med 338, 217–220, 1998

      Massoud BW, Mehrdad V, Baharak T et al.: Botulinum toxin injection versus internal anal sphincterotomy for the treatment of anal fissure. Ann Saudi Med 25, 140–142, 2005

      Mentes BB, Irkörücü O, Akin M et al.: Comparison of botulinum toxin injection and lateral internal sphincterotomy for the treatment of chronic anal fissure. Dis Colon Rectum 46, 232–237, 2003

      Mustafa NA, Cengiz S, Türkyilmaz S et al.: Comparison of topical glyceryl trinitrate ointment and oral nifedipine in treatment of chronic anal fissure. Acta Chir Belg 105, 55–58, 2005

      Richard CS, Gregoire R, Plewes EA et al.: Internal sphincterotomy is superior to topical nitroglycerin in the treatment of chronic anal fissure. Dis Colon Rectum 43, 1048–1057, 2000

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