Temporal trends and treatment patterns in anal fissure management: insights from a multicenter study in Italy.
Humans
Fissure in Ano
/ therapy
Retrospective Studies
Italy
Female
Male
Adult
Middle Aged
Practice Patterns, Physicians'
/ statistics & numerical data
Chronic Disease
Lidocaine
/ administration & dosage
Anal Canal
/ surgery
Nifedipine
/ therapeutic use
Conservative Treatment
/ statistics & numerical data
Dilatation
/ statistics & numerical data
Acute Disease
Treatment Outcome
Sphincterotomy
/ statistics & numerical data
Nitroglycerin
/ therapeutic use
Anal fissure
Botulinum toxin injection
Conservative treatment
Fissurectomy
Sphincterotomy
Surgery
Trends
Journal
Techniques in coloproctology
ISSN: 1128-045X
Titre abrégé: Tech Coloproctol
Pays: Italy
ID NLM: 9613614
Informations de publication
Date de publication:
04 Oct 2024
04 Oct 2024
Historique:
received:
08
05
2024
accepted:
30
08
2024
medline:
4
10
2024
pubmed:
4
10
2024
entrez:
4
10
2024
Statut:
epublish
Résumé
Anal fissure (AF) poses a common challenge in clinical practice, prompting various treatment approaches. This multicenter study, conducted by the Italian Society of Colorectal Surgery, aimed to assess treatment trends in AF over a 10 year period. A survey of proctologists and retrospective analysis of patient records were conducted to evaluate treatment modalities and outcomes across six different clinical scenarios based on AF presentation (acute/chronic) stratified by sphincter function (normal/hypertonic/hypotonic). Analysis of data from 17 principal investigators and 22,016 patients revealed significant variability in treatment approaches, influenced by factors such as symptom duration, anal tone, and surgeon preference. Conservative treatments were commonly utilized, while surgical interventions were reserved for refractory cases. Specifically, pharmaceutical treatment was administered to 66-75% of patients in cases of acute AF and 63-67% for chronic AF, while 10-15% underwent anal dilation, and < 2% received botulinum toxin injection. Among medical treatments, nifedipine with lidocaine and glycerin film-forming ointments were the most utilized. The most performed surgical techniques were fissurectomy and anoplasty, except for patients with chronic AF and hypertonic sphincter where sphincterotomy prevailed. Trends in treatment utilization varied depending on the clinical scenario, with notable shifts observed over time. This study provides insights into the evolving landscape of AF management, highlighting the need for further research to elucidate optimal treatment strategies and improve patient outcomes.
Identifiants
pubmed: 39365369
doi: 10.1007/s10151-024-03011-4
pii: 10.1007/s10151-024-03011-4
doi:
Substances chimiques
Lidocaine
98PI200987
Nifedipine
I9ZF7L6G2L
Nitroglycerin
G59M7S0WS3
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
139Investigateurs
Ambrosini Fabio
(A)
Annicchiarico Alfredo
(A)
Antonacci Nicola
(A)
Ascari Francesca
(A)
Ascenzi Pasquale
(A)
Balla Andrea
(B)
Barugola Giuliano
(B)
Basso Luigi
(B)
Beati Claudio
(B)
Bellato Vittoria
(B)
Benatti Emanuela
(B)
Bertoli Paolo
(B)
Bottini Corrado
(B)
Bracchitta Salvatore
(B)
Cafaro Danilo
(C)
Calussi Marco
(C)
Caminati Filippo
(C)
Candilio Giuseppe
(C)
Cantarella Salvatore
(C)
Carbone Fabio
(C)
Carini Stefano
(C)
Carrino Francesco
(C)
Cestaro Giovanni
(C)
Chessa Antonella
(C)
Ciferri Enrico
(C)
Clementi Marco
(C)
Coco Claudio
(C)
Cocorullo Gianfranco
(C)
Colombo Francesco
(C)
Comba Andrea
(C)
Conti Luigi
(C)
Cracco Nicola
(C)
Cravero Francesca
(C)
Crea Nicola
(C)
Crescenti Fabio
(C)
Cuccomarino Salvatore
(C)
D'Acapito Fabrizio
(D)
D'Onghia Giuliano
(D)
De Rosa Michele
(R)
Di Pietrantonio Daniela
(DP)
Dodi Giuseppe
(D)
Ferrario Luca
(F)
Fontana Tommaso
(F)
Foti Nicola
(F)
Geremia Carmelo
(G)
Giannini Ivana
(G)
Giordano Pasquale
(G)
Giuliani Antonio
(G)
Guaitoli Eleonora
(G)
Laforgia Rita
(L)
Lantone Giuliano
(L)
Lemma Maria
(L)
Lisi Giorgio
(L)
Lobascio Pierluigi
(L)
Lovisetto Federico
(L)
Lucci Enrico
(L)
Madeddu Francesco
(M)
Magnani Costantino
(M)
Mascali Davide
(M)
Merlini David
(M)
Milito Giovanni
(M)
Miro Antonio
(M)
Moggia Elisabetta
(M)
Monaci Iacopo
(M)
Mozzon Marta
(M)
Navarra Luca
(N)
Oggianu Angelo
(O)
Orlandi Simone
(O)
Palumbo Alessio
(P)
Passaro Umberto
(P)
Pata Francesco
(P)
Pecorella Giuseppe
(P)
Pedrazzani Corrado
(P)
Piccolo Davide
(P)
Poli Giulia
(P)
Rinaldi Marcella
(R)
Ripetti Valter
(R)
Rizzo Salvatore
(R)
Rocco Giuseppe
(R)
Sacco Michele
(S)
Saroglia Giuliano
(S)
Scotto Bruno
(S)
Selvaggi Lucio
(S)
Silvestri Vania
(S)
Soldini Gabriele
(S)
Tamini Nicolò
(T)
Tanda Cinzia
(T)
Terrosu Giovanni
(T)
Testa Alessandro
(T)
Tomasicchio Giovanni
(T)
Turati Luca
(T)
Ursino Natale
(U)
Vannelli Alberto
(V)
Viola Gabriele
(V)
Violante Tommaso
(V)
Zigiotto Daniele
(Z)
Informations de copyright
© 2024. The Author(s).
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