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Am Surg 2021 Jun 7:31348211023446. Epub 2021 Jun 7.

Division of Colon and Rectal Surgery, 21886Advocate Lutheran General Hospital, Park Ridge, IL, USA.

Background: Chronic anal fissure (CAF) is commonly treated by colorectal surgeons. Pharmacological treatment is considered first-line therapy. An alternative treatment modality is chemical sphincterotomy with injection of botulinum toxin (BT). Read More

Asian J Surg 2021 Jun 28;44(6):932-933. Epub 2021 May 28.

General Surgery Unit, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Italy; Postgraduate Medical School in General Surgery, University of Palermo, Palermo, Italy.

Asian J Surg 2021 May 26. Epub 2021 May 26.

General Surgery Unit - Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Italy.

Ann Ital Chir 2021 ;92:180-182

Aim: The author proposes a new, original Syndrome, observing the relationship between some of the most frequent anal pathologies, apparently different from each other in terms of morphological aspect and symptomatologic expression, but united by the same pathogenic cause, represented by the hypertonicity of the anal sphincter apparatus. There are already descriptions of other "syndromes" of the pelvic floor, inaccurate and subject to different interpretations. The proposed syndrome, instead, called Anal Sphincter Syndrome - ASS (in Italian SSA - Sindrome dello Sfintere Anale) presents clarity on the determining cause (sphincter hypertonicity) and descriptive simplicity, including only two welldefined pathological conditions: anal fissure and anal thrombosis; other ancillary conditions or symptoms are inconstantly possible, but not decisive. Read More

Cir Esp 2021 May 8;99(5):361-367. Epub 2020 Jul 8.

Hospital Universitari Mútua Terrassa, Tarrasa, España.

Introduction: During the state of alarm established in Spain due to the COVID-19 pandemic, most of the face-to-face outpatient consultations were cancelled and a telephone consultation was established to follow up coloproctological patients. The objective of this study was to analyse the efficacy of telemedicine (by telephone) in monitoring patients in a coloproctology unit, in the context of the COVID-19 pandemic.

Method: Prospective descriptive study of consecutive patients in a single centre. Read More

Tech Coloproctol 2021 May 13. Epub 2021 May 13.

Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy.

Background: Anal fissure (AF) is a common, painful disease that strongly affects patients' quality of life, however, no scoring system to assess the severity of AF is available in the literature. The aim of this study was to set up and validate a reliable scoring system to quantify the severity of AF, to be used in prospective trials comparing the efficacy and the outcomes of surgical or medical treatments.

Methods: The study was conducted on patients with acute or chronic AF and a control group in a tertiary centre for coloproctology in June 2020-September 2020. Read More

Visc Med 2021 Mar 5;37(2):128-133. Epub 2020 May 5.

Department of Pathology and Surgery, Miguel Hernández University, San Juan de Alicante, Spain.

Introduction: Scientific literature on determining patterns of personality traits in patients with anal fissure is limited.

Objectives: To determine whether certain common psychological traits are associated with anal fissure.

Methods: A case-control study was carried out in Spain in 2016-2017. Read More

Asian J Surg 2021 May 5. Epub 2021 May 5.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; The University of Sydney, Discipline of Surgery, Sydney, New South Wales, Australia.

Background: Lateral internal sphincterotomy (LIS) remains the gold standard surgical approach for the management of chronic anal fissures (CAF). The procedure however, is complicated by the risk of postoperative incontinence. Intrasphincteric Botulinum Toxin (BT) has gained popularity as an alternative approach, despite being inferior to LIS with regards to cure rates. Read More

Acta Chir Belg 2021 Apr 24:1-14. Epub 2021 Apr 24.

Department of Surgery, Bursa Medicana Hospital, Bursa, Turkey.

Objectives: There are few published data on the optimized use of botulinum toxin A (BTA) for the treatment of chronic anal fissure (CAF). The aim of this study was to investigate the effect of injection of 100 IU botulinum toxin A into the internal anal sphincter at the side opposite of the fissure, using an anal retractor, sedation, and perianal transcutaneous pudendal nerve block.

Methods: The prospectively maintained data of 132 patients who underwent BTA injection for CAF were retrospectively analyzed. Read More

Am Surg 2021 Apr 16:31348211011104. Epub 2021 Apr 16.

Department of Anesthesiology & Critical Care, 64052Pamukkale University School of Medicine, Denizli, Turkey.

Background: Currently, the lateral internal sphincterotomy is the treatment of choice for a chronic anal fissure (CAF). However, the length of the internal sphincter incision varies, due to lack of standardization. Insufficient length increases the risk of recurrence. Read More

Drugs Context 2021 26;10. Epub 2021 Mar 26.

Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.

Background: Despite being a common problem in childhood, functional constipation is often difficult to manage. This article provides a narrative updated review on the evaluation, diagnosis and management of childhood functional constipation.

Methods: A PubMed search was performed with Clinical Queries using the key term 'functional constipation'. Read More

Int Cancer Conf J 2021 Apr 5;10(2):139-143. Epub 2021 Jan 5.

Department of Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan.

Colorectal cancer (CRC) rarely spreads by implantation. We report a case of implantation of rectosigmoid cancer in an anal fissure. A 70-year-old woman with a 15-year medical history of anal fissure was referred to our hospital with anal pain of 3-month duration. Read More

J Ethnopharmacol 2021 Jun 27;274:114070. Epub 2021 Mar 27.

Jiangxi Key Laboratory of Natural Products and Functional Food, Jiangxi Agricultural University, Nanchang, 330045, China. Electronic address:

Ethnopharmacological Relevance: Egg yolk oils (EYO) is a traditional Chinese medicine obtained from Gallus gallus domesticus Brisson, which has been used to treat inflammatory related diseases such as cheilitis, ulceration and acute anal fissure. However, the detailed anti-inflammatory mechanism of EYO is still unknown.

Aim Of The Study: The anti-inflammatory activity and mechanism of EYO were investigated in tumor necrosis factor (TNF)-α induced Caco-2 cells. Read More

Turk J Surg 2020 Dec 29;36(4):347-352. Epub 2020 Dec 29.

South Tees Hospitals Nhs Foundation Trust, Clinic of General Surgery, Middlesbrough, United Kingdom.

Objectives: Surgical management of chronic anal fissure can result in permanent fecal incontinence. Topical treatments have a lower risk of severe complication and are less expensive than surgical intervention. Rates of healing and compliance with topical agents vary in the reported literature. Read More

Turk J Surg 2020 Sep 28;36(3):264-270. Epub 2020 Sep 28.

Sisli Hamidiye Etfal Training And Research Hospital, General Surgery, Istanbul, Turkey.

Objectives: Anal fissure is a common health problem that affects the quality of life of young patients. The aim of our study was to benchmark results of lateral internal sphincterotomy (LIS) and botulinum toxin injection in the treatment of chronic anal fissure.

Material And Methods: This multi-center, retrospective study used data from 135 chronic anal fissure patients. Read More

Surgery 2021 Mar 22. Epub 2021 Mar 22.

Colorectal Surgical Unit, Department of Surgery, Infermi Hospital, Biella, Italy.

Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field.

Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. Read More

Ann Ital Chir 2020 Dec 21;9. Epub 2020 Dec 21.

Introduction: Aetiopathogenesis of Chronic Anal Anterior Fissure (CAAF) remains poorly understood. Some anatomical, clinical and functional features suggest that pathophysiology may be linked to a reduced anal canal pressure. LIS appear illogical as a treatment for CAAF and the employ of techniques aiming to save the integrity of the sphincterial system appears more sensible. Read More

ANZ J Surg 2021 Mar 16. Epub 2021 Mar 16.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Background: The pursuit of better management for haemorrhoidal disease (HD) is far from over, and even with the latest surgical procedures, none of the treatment options is close to perfect. The aims of this study were to review our experience with patients treated for symptomatic HD, compare the different treatment strategies in terms of complication and recurrence rates and determine predictors of recurrence.

Methods: A total of 1958 patients who underwent a procedure for HD performed by a single colorectal consultant surgeon between 2000 and 2015 were reviewed. Read More

Tech Coloproctol 2021 04 9;25(4):489-492. Epub 2021 Mar 9.

Department of General Surgery and Surgical Specialties "Paride Stefanini", Sapienza University of Rome, Rome, Italy.

BMC Complement Med Ther 2021 Feb 24;21(1):75. Epub 2021 Feb 24.

Department of Surgery, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon.

Background: Anal fissure is a common complication of the anorectal region and one of the most reported causes of anal pain. Acute anal fissure can be cured by surgery or medical treatment. There is an increase in the use of topical therapy for the treatment of anal fissures. Read More

JAMA 2021 02;325(7):702

Division of Colorectal Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles.

JAMA 2021 Feb;325(7):688-689

Division of Colorectal Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles.

Eur J Pediatr 2021 Jun 2;180(6):1867-1874. Epub 2021 Feb 2.

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.

Group A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. Read More

J Family Med Prim Care 2020 Nov 30;9(11):5800-5801. Epub 2020 Nov 30.

Department of Colorectal Surgery, Indus International Hospital, Mohali, Punjab, Haryana, India.

J Family Med Prim Care 2020 Nov 30;9(11):5652-5657. Epub 2020 Nov 30.

Department of Surgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Background: Chronic anal fissure is a common condition which is classically treated by surgery which may lead to incontinence. Recently medical treatment in form of calcium channel blockers (CCB) has gained interest.

Aims: The aim of this study is to compare the effectiveness of local Nifedipine and Diltiazem with lignocaine as control. Read More

Eur Urol Focus 2021 Jan 29. Epub 2021 Jan 29.

Kantonsspital St. Gallen, St. Gallen, Switzerland.

Context: Patients with chronic pelvic pain syndrome (CPPS) may have pain refractory to conventional management strategies. Botulinum toxin A (BTX-A) is a potential therapeutic option.

Objective: To evaluate the benefits and harms of BTX-A injections in the treatment of CPPS. Read More

Dis Colon Rectum 2021 Jun;64(6):714-723

KTO Karatay University, Faculty of Medicine, Department of General Surgery, Konya, Turkey.

Background: Anal fissure is one of the most common benign anal disorders, and medical treatments play an important role in its management.

Objective: The purpose of this study was to investigate the short-term effects and success of platelet-rich plasma in the treatment of chronic anal fissure.

Design: The study is a 2 parallel group, randomized, controlled clinical trial. Read More

Niger J Clin Pract 2020 Dec;23(12):1639-1642

Department of General Surgery, Acibadem Health Group, Fulya Hospital, Istanbul, Turkey.

Background: Chronic anal fissure is a common disease of the anoderm. Botulinum toxin injection has recently been recommended. However, the injection sites are still debatable. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2020 Dec;23(12):1194-1199

Department of Colorectal and Anal Surgery, the Sixth Affiliated Hospital, Sun Yet-sen University, Guangzhou, Guangdong 510655, China.

Currently, various treatments such as hemorrhoidectomy, ligation and sclerotherapy injection can be applied in grade II or III hemorrhoids. This study aims to compare the clinical efficacy, safety and economy between Shaobei injection and elastic band ligation in treating patients with grade II or grade III hemorrhoids. A retrospective cohort study was used. Read More