Treatment of chronic anal fissure with botulinic toxin type a
Charúa Guindic, L.; Fonseca Muñoz, E.; Guerra Melgar, L.R.; Avendaño Espinosa, O.; García Pérez, N.J.; Charúa Levy, E.ía.
Revista de Gastroenterologia de Mexico 72(1): 22-28
2007
ISSN/ISBN: 0375-0906 PMID: 17685196 Document Number: 612270
Anal fissure is a disease that generally affects to young people, but it can present at any age. To show our experience in the treatment of chronic anal fissure with botulinum toxin type A. This is a prospective, experimental and longitudinal study realized in the Coloproctology Unit in the General Hospital of Mexico City and in Medical North of Monterrey, Mexico, between June 2002 and November 2004. Direct variable was healing with 25 units of botulinum toxin. Secondary variables: age, sex, symptomatology, evolution time, localization of fissure, evolution after application of botulinum toxin, complications and time ofhealing. 35 (67.30%) were female and 17 (32.69%), male; age range, 21 to 64 years, with a medium of 43. At twelve months of toxin, application of 34 (65.38%) patients were asymptomatic, but in four fissure persisted. The other 18 patients were operated on due to persistence of the fissure. In a follow up of 18 months, 30 patients cured (57.69%), 4 improved (7.69%) and 18 (34.61%) were failures; one died by myocardial infarction and there were no recurrences. Botulinum toxin type A is a good alternative in the treatment of chronic anal fissure. Healing or improved with the application of 25 units of botulinum toxin was 65.38%.