Search Our Scientific Publications & Authors

BMC Cancer 2019 Apr 23;19(1):374. Epub 2019 Apr 23.

Department of Urology, National Cancer Institute, 1 Santariskiu Str., LT-08406, Vilnius, Lithuania.

Background: Here we present the first cases of prostate cancer solitary metastasis to anal canal.

Case Presentation: A 67-year-old male patient underwent radical prostatectomy with ilio-obturator lymphonodectomy in 2016 due to poorly differentiated ductal adenocarcinoma (Gleason 4 + 5(40%) = 9) pT3bN0. Two months later increasing PSA rate was noted and the patient started adjuvant intermittent androgen deprivation therapy combined with radiotherapy. Read More

Rev Prat 2019 Jan;69(1):67-70

Maison de santé protestante de Bordeaux-Bagatelle, Talence, France.

Main traps in proctology. Traps are numerous in proctology. Avoiding the clinical examination is the most common. Read More

Pediatr Neurol 2019 Feb 20. Epub 2019 Feb 20.

Pediatric Department, University Hospital Of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece. Electronic address:

Background: Tolosa-Hunt syndrome (THS) is a rare condition in children characterized by painful ophthalmoplegia caused by inflammation of unknown etiology in the cavernous sinus, superior orbital fissure, or orbital apex. Our main purpose was to report two pediatric cases of THS, a typical one and another extremely rare one preceded by facial palsy.

Methods: Both cases were diagnosed with THS based on the 2013 International Classification of Headache Disorders (ICHD-3 beta) criteria. Read More

Tech Coloproctol 2019 Apr 10. Epub 2019 Apr 10.

Department of Surgery, Pelvic Floor Centre, Skåne University Hospital-SUS, Lund University, 205 02, Malmö, Sweden.

Background: The aim of the present study was to evaluate percutaneous tibial nerve stimulation (PTNS) for treatment resistant chronic anal fissure.

Methods: Consecutive patients with chronic anal fissure were treated with neuromodulation via the posterior tibial nerve between October 2013 and January 2014. Patients had PTNS for 30 min on 10 consecutive days. Read More

Chirurg 2019 Mar 25. Epub 2019 Mar 25.

Klinik für Gastroenterologie und interventionelle Endoskopie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland.

Rectal bleeding is a frequent symptom in proctology. In most cases frequent causes, such as anal fissures and hemorrhoidal disease can be diagnosed and treated using a structured patient history and basic proctological diagnostic assessment; however, it is not uncommon for proctitis to be the reason for rectal bleeding, which necessitates interdisciplinary diagnostics and treatment. In addition to proctitis associated with chronic inflammatory bowel disease, prolapse-induced, radiogenic, ischemic, infectious types and proctitis associated with sexually transmitted diseases represent important differential diagnoses. Read More

Indian J Gastroenterol 2019 Feb 1. Epub 2019 Feb 1.

Department of Gastroenterology, Gleneagles Global Health City, 439, Cheran Nagar, Chennai, 600 100, India.

The causative factors for hemorrhoids, anal fissure, and solitary rectal ulcer syndrome (SRUS) are poorly understood. The study was done to identify the prevalence of fecal evacuation disorders in patients with anal fissure, hemorrhoids, and SRUS using anorectal manometry (ARM). Retrospective analysis of ARM data from three centers across India was done. Read More

Colorectal Dis 2019 Jan 31. Epub 2019 Jan 31.

Department of Surgery, Cantonal Hospital Baden, Baden, Switzerland.

Aim: Laser haemorrhoidoplasty is associated with minimal postoperative pain and good symptom improvement in the short-term. However, less is known about its long-term efficacy. This study aims to determine the short- and long-term outcomes of laser haemorrhoidoplasty. Read More

J Surg Case Rep 2019 Jan 24;2019(1):rjy363. Epub 2019 Jan 24.

University of Nicosia Medical School, Nicosia, Cyprus.

A 44-year-old male patient diagnosed with Anal Fissure and Stage II Hemorrhoids in 2013. He has been suffering ever since, avoiding surgery, using local analgesic and anti-hemorrhoidal crèmes. Physical examination in February 2017, showed a chronic character of his problem and hemorrhoids to have progressed to Stage III. Read More

Turk J Surg 2018 Dec 1;34(4):349-350. Epub 2018 Dec 1.

Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula, India.

Dis Colon Rectum 2019 02;62(2):e8-e9

Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, Geisel School of Medicine, Lebanon, NH.

Dis Colon Rectum 2019 02;62(2):e8

Garg Fistula Research Institute, Panchkula, Haryana, India.

Dis Colon Rectum 2019 Jan 8. Epub 2019 Jan 8.

Division of Colorectal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

Background: A large proportion of patients with anorectal complaints are referred to colorectal surgeons with the label of hemorrhoids.

Objective: The purpose of this study was to review presenting symptoms and frequency of accurate diagnosis, as well as to analyze determinants of misdiagnosis to guide educational endeavors.

Design: This was a retrospective study. Read More

World J Clin Pediatr 2018 Oct 25;7(4):89-104. Epub 2018 Oct 25.

2 Department of Pediatrics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Emergency Hospital for Children, Cluj-Napoca 400177, Romania.

Perianal infectious dermatitis (PID) represents a superficial inflammation of the perianal skin, which is of bacterial origin (classically, ). This narrative review aims to critically review and summarize the available scientific literature regarding pediatric PID, being the first of its kind, to the best of the author's knowledge. It also reports the first cases of Romanian children with PID. Read More

Am Surg 2018 Dec;84(12):e538-e540

JAAPA 2019 Jan;32(1):1-7

Yasmine Hubbard is a surgical PA at St. Peter's Health Partners and Affiliated Hospitals in Albany and Troy, N.Y. Denise Rizzolo is an associate professor in the School of Nursing at Kean University in Union, N.J., and an assistant clinical professor in the Pace Completion Program in the Department of Physician Assistant Studies in New York City. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Anorectal pain is common but often misdiagnosed, and patients may suffer in silence if they are too uncomfortable discussing the topic with their healthcare provider. This article reviews rectal anatomy and the signs and symptoms of several common anorectal conditions and how to manage them. Read More

Diagn Interv Radiol 2019 Jan;25(1):21-27

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. Read More

Int J Pharm 2019 Feb 21;557:53-65. Epub 2018 Dec 21.

Faculty of Medicine, Medical University, "Prof. Dr. Paraskev Stoyanov", 55 Marin Drinov str., Varna, Bulgaria.

Diltiazem hydrochloride, topically applied at 2% concentration, is considered effective for the treatment of chronic anal fissures, although it involves several side effects among which anal pruritus and postural hypotension. To test the hypothesis that a sustained delivery system of diltiazem hydrochloride may be helpful for the treatment of chronic anal fissures, in the present study we evaluated the potential of gels containing diltiazem hydrochloride entrapped in microsponges. Such microsponges were based on Eudragit RS 100 and the effect of some formulation variables was assessed by a 2 full factorial screening design. Read More

Khirurgiia (Mosk) 2018(11):89-95

Municipal Clinical Hospital #24 of Moscow Healthcare Department, Moscow, Russia.

Etiology, epidemiology and pathophysiology of anal fissure are examined in the article in order to determine the most optimal treatment strategy. The authors concluded that the most effective treatment is combined approach using both minimally invasive surgery and various medicines for anal spasm reduction. Read More

J Surg Case Rep 2018 Nov 27;2018(11):rjy320. Epub 2018 Nov 27.

General Surgery Department, Monash Health, Melbourne, Australia.

We present the case of a 29-year-old woman who attended a surgical outpatient clinic with symptoms of perianal fissure due to syphilitic infection. This uncommon aetiology of a common condition is often alluded to in textbooks, but little information exists in the scientific literature regarding the pathogenesis, presentation and treatment of fissure-in-ano secondary to syphilis. We present the case and an overview of the topic aimed at surgeons and clinicians who manage patients with perianal pathology. Read More

Clin Transl Gastroenterol 2018 Nov 23;9(11):210. Epub 2018 Nov 23.

Drug Development Services, Pharmacy and Pharmaceutical Technology and Physical Chemistry Department, University of Barcelona, Barcelona, Spain.

Objective: The aim of this study is to evaluate the efficacy and safety of a topical formulation containing lidocaine plus diclofenac (CLIFE1) compared to lidocaine (CLIFE2), to decrease pain in benign anorectal surgery (BARS) to date not evaluated. More than 50% of patients undergoing BARS, especially hemorrhoidectomy, suffer from moderate and severe postoperative pain. This remains an unresolved problem that could be addressed with the new CLIFE1 topical treatment. Read More

Drug Deliv 2018 Nov;25(1):1672-1682

a Faculty of Pharmacy, Department of Pharmaceutics , Mansoura University , Mansoura , Egypt.

To treat anal fissure, internal anal sphincterotomy may be associated with surgical risks and incidence of incontinence. Botulinum toxin injection into the anal sphincter is invasive and expensive. Headache and hypotension hindered topical treatment with glyceryl trinitrate. Read More

Colorectal Dis 2019 Feb 27;21(2):226-233. Epub 2018 Nov 27.

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

Aim: The aim was to determine whether or not the clinical management of anal fissure in Australia and New Zealand accords with published guidelines.

Methods: A comprehensive survey based on common clinical scenarios was distributed to 206 colorectal surgeons in Australia and New Zealand.

Results: The response rate was 44% (91 surgeons). Read More

Curr Treat Options Gastroenterol 2018 Dec;16(4):541-547

Sackler Faculty of Medicine, Tel Aviv University, P.O.B 39040, 69978, Ramat Aviv, Israel.

Purpose Of Review: To overview the current medical literature on the efficacy of botulism toxin treatment (BTX-A) for lower gastrointestinal disorders (GIT).

Recent Findings: BTX-A was found to have a short-term efficacy for the treatment of dyssynergic defecation. Surgical treatment was found to be more effective than BTX-A for the healing of chronic anal fissures, and BTX-A can be considered when surgery is undesirable. Read More

Gynecol Obstet Fertil Senol 2018 12 29;46(12):913-921. Epub 2018 Oct 29.

Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.

Objectives: The aim of this review was to agree on a definition of the obstetric anal sphincter injuries (OASIS), to determine the prevalence and risk factors.

Methods: A comprehensive review of the literature on the obstetric anal sphincter injuries (OASIS), establishment of levels of evidence (NP), and grades of recommendation according to the methodology of the recommendations for clinical practice.

Results: To classify obstetric anal sphincter injuries (OASIS), we have used the WHO-RCOG classification, which lists 4 degrees of severity. Read More

Pan Afr Med J 2018 20;30:147. Epub 2018 Jun 20.

Service d'Hépato-gastroentérologie, Faculté de Médecine et de Pharmacie de Fès, Université Sidi Mohammed Ben Abdellah, Fès, Maroc.

Many disorders of the digestive tract cause cutaneous manifestations that may be an indication of an underlying condition; hence dermatologist plays a key role in recommending that the patient see a gastroenterologist. Conversely, gastroenterologist often sees patients with mucocutaneous lesions suggesting possible association with well-known digestive disorders. Chronic inflammatory bowel diseases are the typical example of this essential collaboration between the two specialities. Read More

Cutis 2018 09;102(3):E22-E23

Department of Dermatology, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, USA.

Asian J Surg 2018 Oct 24. Epub 2018 Oct 24.

İzmir Katip Çelebi University, Atatürk Training and Research Hospital, Department of General Surgery, Basın Sitesi, İzmir, Turkey. Electronic address:

Background: Anal fissure which is defined as a longitudinal tear in anoderm under the dentate line is one of the most common benign diseases of anorectal area, and due to the severe pain during the defecation and emotional stress that it causes may reduce people's quality of life. There are several treatment methods such as medical substances and surgical procedures. In this retrospective study, we aimed to evaluate the safe and adequate option of lateral internal sphincterotomy (LIS) in chronic anal fissure treatment. Read More

J Med Case Rep 2018 Oct 24;12(1):315. Epub 2018 Oct 24.

Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.

Background: Hereditary polyglucosan inclusion body myopathy of the internal anal sphincter is a rare cause of proctalgia fugax and constipation. Treatment options are explored.

Case Presentation: A 61 year-old Caucasian woman presented with an 18-year history of severe anal pain and constipation. Read More

Turk J Surg 2018 Sep 11;34(4):286-289. Epub 2018 Sep 11.

Department of General Surgery, Kanuni Training and Research Hospital, Trabzon, Turkey.

Objective: Acute anal fissure is a very common disorder of the anorectal region. Its most widely used treatment method is the medications given in addition to conservative therapies. The objective of the present study was to investigate the effects of local metronidazole use in the treatment of acute anal fissure on the symptoms and remission processes of the patients. Read More

Turk J Surg 2018 Sep 13;34(4):276-281. Epub 2018 Sep 13.

Department of Psychiatry, Edremit State Hospital, Ankara, Turkey.

Objective: The aim of the present study was to evaluate the subjective sleep quality in patients with anorectal disorder, to determine the factors associated with subjective sleep quality, and to explore the relationship between subjective sleep quality and quality of life.

Material And Methods: This descriptive study was conducted between April 8, 2015 and April 12, 2016. The research population consisted of 284 patients who attended the general surgery outpatient clinics of Konya Military Hospital and were subsequently diagnosed with one of the four most common anorectal disorders (hemorrhoidal disease, anal fissure, anorectal abscess/fistula, and sacrococcygeal pilonidal disease). Read More

J Perianesth Nurs 2018 Oct 28;33(5):640-650. Epub 2017 Sep 28.

Purpose: The aim of this study was to evaluate the effectiveness of preoperative planned education about lifestyle modifications on knowledge, anxiety level, and postoperative problems of the patients with benign perianal disease.

Design: The study was a quasi-experimental design.

Methods: The sample was a total of 102 patients undergoing surgical procedure for hemorrhoid and fissure in the general surgery unit of a state hospital in Turkey. Read More

Khirurgiia (Mosk) 2018(8. Vyp. 2):73-77

Pirogov Russian Research Medical University, Chair of Faculty-Based Surgery of the 1st Faculty of Medicine, Moscow, Russia.

Surgical treatment of the anal fissure is associated with unreasonably high risks of delayed development of fecal incontinence to gas or liquid stool. Standardized sphincter-preserving therapy, based on the pharmacological reduction of increased internal anal sphincter tone (chemical sphincterotomy) allows to improve significantly the results of the non-surgical approach of treating one of the most common pathology in proctological practice. Our work presents a retrospective analysis of the treatment of 295 patients with anal fissure treated with diltiazem ointment, nifedipine ointment, nitroglycerin ointment and botulinum toxin A. Read More

Dis Colon Rectum 2018 Oct;61(10):1223-1227

Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

Background: Nonoperative management has been reported to decrease symptoms from common anorectal conditions such as chronic anal fissures and hemorrhoids. The effects of these interventions on bowel function are unknown.

Objective: This study aims to perform a prospective evaluation of patient-reported outcomes of bowel function on nonoperative management for chronic anal fissures and hemorrhoid disease. Read More

Acta Chir Belg 2018 Sep 7:1-7. Epub 2018 Sep 7.

a Department of Ambulatory Surgery , Ghent University , Ghent , Belgium.

Background: Ambulatory surgery for anorectal procedures has become widely accepted. Recent reviews recommend a multimodal approach to pain management. However, these recommendations are largely based on single intervention studies. Read More

Colorectal Dis 2019 Jan 21;21(1):48-58. Epub 2018 Sep 21.

Pierre Fabre SA, Boulogne-Billancourt, France.

Aim: Current questionnaires designed to evaluate the burden of haemorrhoidal disease ignore symptoms such as bleeding, pain and itching. A specific questionnaire is needed to evaluate the global impact of anal disorders on patients' daily lives.

Method: We developed a questionnaire (HEMO-FISS-QoL) to assess the symptom burden of anal disorders and administered it to 256 patients (mean age 46. Read More

Surg Technol Int 2018 Nov;33:105-109

Clinique Clementvielle, Montpellier, France.

Background: Anal fissure is a common proctological condition that is usually defined as an anodermal ulcerative process starting from the posterior commissure to the dentate line. The objective of this study was to evaluate the resolution rate of anal fissure through the use of conservative management in patients grouped according to our newly proposed classification. A secondary purpose was to quantify the recurrence rates at 2-years follow-up in each group. Read More

Rev Med Suisse 2018 Aug;14(614):1394-1396

Département des urgences, HNE, site de Pourtalès, 45 rue de la Maladière, 2000 Neuchâtel.

Hemorrhoids affect up to 85 % of pregnant women during the last two trimesters. The maximum incidence for anal fissure is 20 %. One of the common risk factors is constipation promoted during pregnancy. Read More

HIV Med 2018 11 6;19(10):716-723. Epub 2018 Aug 6.

Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

Objectives: HIV-infected individuals are at increased risk of anal cancer. Screening for anal cancer precursors using high-resolution anoscopy (HRA) may be clinically beneficial. In this study, we examined patient tolerability of this procedure. Read More

Cutis 2018 06;101(6):E8-E10

Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.

Georgian Med News 2018 Jun(279):12-18

Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi; I.Ya. Horbachevsky Ternopil State Medical University, Ministry of Healthcare of Ukraine; Ternopil Ivan Puluj National Technical University; State Agrarian and Engineering University in Podilya, Ukraine.

Chronic anal fissures (CAF) are considered to be the illness with chronic course and characterized by frequent relapses. Although today the attention of researchers concerning the role of biofilm bacterial forms in pathogenesis of this pathology remains inadequate. Тherefore we investigated biofilms density of bacteria isolated from CAF and determined the current density possessing an optimal bactericidal effect on bacteria and destruct microbial biofilms. Read More

Tech Coloproctol 2018 07 18;22(7):545-551. Epub 2018 Jul 18.

Department of Colorectal Surgery, Southampton General Hospital, University Hospitals Southampton NHS Trust, Southampton, UK.

Background: Botulinum toxin injected into the internal anal sphincter is used in the treatment of chronic anal fissure but there is no standardised technique for its administration. This randomised single centre trial compares bilateral (either side of fissure) to unilateral injection.

Methods: Participants were randomised to receive bilateral (50 + 50 units) or unilateral (100 units) Dysport injections into the internal anal sphincter in an outpatient setting. Read More

Ann Surg Oncol 2018 Sep 6;25(9):2641. Epub 2018 Jul 6.

Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA.

Introduction: The management of perirectal tumors often requires rectal wall resection, and sometimes a complete proctectomy is required. Access to posterior perirectal masses via a posterior, transcoccygeal approach (Kraske procedure) avoids dissection of the intraperitoneal rectum.

Patient: The patient was a 63-year-old male who presented to his primary care physician with debilitating perirectal pain of several months' duration. Read More

Colorectal Dis 2018 Dec 3;20(12):1109-1116. Epub 2018 Aug 3.

Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent University, Gent, Belgium.

Aim: The aim was to determine the prevalence and risk factors of anal symptoms prepartum and postpartum.

Method: A prospective observational cohort study was carried out in Ghent University Hospital, Belgium. Ninety-four pregnant women between their 19th and 25th week of pregnancy were included. Read More

J Surg Res 2018 09 9;229:283-287. Epub 2018 May 9.

Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine, Lebanon, New Hampshire. Electronic address:

Background: Surgery for anorectal diseases is thought to cause significant pain postoperatively. There is little known regarding standardized opioid-prescribing trends and patient use following surgery for anorectal diseases. We aimed to evaluate and analyze opioid-prescribing trends and patient use for outpatient anorectal operations. Read More

Indian J Surg 2018 Apr 1;80(2):203-204. Epub 2018 Feb 1.

1Department of Surgery, GTB Hospital and University College of Medical Sciences, University of Delhi, Delhi, India.

Medicine (Baltimore) 2018 Jun;97(22):e10836

Department of Pathology.

Rationale: Ulcerative skin tuberculosis (TB) is a rare form of extrapulmonary TB.

Case Report: We present a case of a 65-year-old patient with perianal ulcer, which had been present for 1 year. Anamnesis revealed he had been persistently coughing for the same period of time. Read More

Ann Ital Chir 2018 ;89:330-336

Aims: We aim to test and compare the effects of Flavonoids (Fs) and Centella asiatica (Ca), and the traditional treatment to find out which best deals with healing time, bleeding and pain in the treatment of chronic Anal Fissure (AF). Materials of Study: 98 outpatients were divided randomly into treated (either Fs or Ca) and control group. The control group (Group C, n=32) received the traditional treatment along with the other two subgroups which were treated, additionally, with Fs (Group A, n=30) or Ca (Group B, n=36). Read More

Int J Colorectal Dis 2018 Oct 19;33(10):1461-1467. Epub 2018 May 19.

Colorectal Surgery Unit, General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Egypt.

Background: Lateral internal anal sphincterotomy (LIS) is considered the treatment of choice for chronic anal fissure. This study aimed to compare the outcome of standard LIS and posterolateral internal sphincterotomy (PLIS) at 5 o'clock position as regards healing of anal fissure, improvement in symptoms, and complications.

Methods: Patients with chronic anal fissure were randomly allocated to one of two groups; group I underwent PLIS and group II underwent LIS. Read More

Dis Colon Rectum 2018 Jul;61(7):824-829

Department of Surgery, University of Vermont Medical Center, Burlington, Vermont.

Background: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Read More