Conservative treatment of anal fissures: P183

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Aim:To evaluate conservative treatment for anal fissures by assessing topical glyceryl trinitrate (GTN) ointment (Rectogesic®) and/or Dilatan® dilatators with a cicatrizing oinment.Method:Between April 2008 and April 2010, 168 patients were diagnosed with an anal fissure. 60 (38 M and 22 F) patients were treated with GTN while 108 were treated with anal ditatators and a cicatrizating oinment.Results:In the GTN group, 33 patients (55%) healed, seven (11.6%) improved and nine (15%) failed to heal. We observed four patients who dropped out (6.67%), four (6.67%) had interrupted therapy2010 The Authorsfor severe headaches and three for cost of the therapy. During median follow up of 6 months, four (6.67%) patients recurred. When we consider the dilatation group, 49 patients healed (45.37%), 21 improved (19.45%), and 14 (12.9%) failed to heal. We observed 24 (22.2) patients who dropped out. During follow up, two patients (1.8%) recurred. If we eliminate patients who dropped out in both groups the rate of healing is 59% in the GTN group and 58.3% in the dilatator group.Conclusion:Conservative treatment is effective in up to 70% of patients treated. Combination of two therapies could improve results. 10-15% of patients require a surgicalprocedure.

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