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Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals.
Cir Esp 2018; 96(1):18-24CE

Abstract

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.

Authors+Show Affiliations

Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España. Electronic address: mmar30052@gmail.com.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.Hospital General Universitario de Elche, Servicio de Cirugía General y del Aparato Digestivo, Elche, Alicante, España.

Pub Type(s)

Journal Article

Language

eng spa

PubMed ID

29246589

Citation

Aguilar, M Del Mar, et al. "Results of the National Survey On the Treatment of Chronic Anal Fissure in Spanish Hospitals." Cirugia Espanola, vol. 96, no. 1, 2018, pp. 18-24.
Aguilar MDM, Moya P, Alcaide MJ, et al. Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. Cir Esp. 2018;96(1):18-24.
Aguilar, M. D. M., Moya, P., Alcaide, M. J., Fernández, A., Gómez, M. A., Santos, J., ... Arroyo, A. (2018). Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. Cirugia Espanola, 96(1), pp. 18-24. doi:10.1016/j.ciresp.2017.09.014.
Aguilar MDM, et al. Results of the National Survey On the Treatment of Chronic Anal Fissure in Spanish Hospitals. Cir Esp. 2018;96(1):18-24. PubMed PMID: 29246589.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. AU - Aguilar,M Del Mar, AU - Moya,Pedro, AU - Alcaide,M José, AU - Fernández,Alba, AU - Gómez,M Amparo, AU - Santos,Jair, AU - Calpena,Rafael, AU - Arroyo,Antonio, Y1 - 2017/12/13/ PY - 2016/12/07/received PY - 2017/09/11/revised PY - 2017/09/28/accepted PY - 2017/12/17/pubmed PY - 2018/9/28/medline PY - 2017/12/17/entrez KW - Chronic anal fissure KW - Encuesta de salud KW - Fisura anal crónica KW - Health survey KW - Manejo terapéutico KW - Therapeutic management SP - 18 EP - 24 JF - Cirugia espanola JO - Cir Esp VL - 96 IS - 1 N2 - 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. SN - 1578-147X UR - https://www.unboundmedicine.com/medline/citation/29246589/Results_of_the_national_survey_on_the_treatment_of_chronic_anal_fissure_in_Spanish_hospitals L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0009-739X(17)30234-8 DB - PRIME DP - Unbound Medicine ER -