Follow-up with a questionnaire of Chronic Anal Fissures (CAF) treated with diltiazem 2%: LTP37

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Aim:To analyze the results with Diltiazem 2% over 4 years.Method:Inprevious studies with short and half term follow-up of Diltiazem 2% in CAF our reported healing rate was 78.8% and 73.9% respectively. CAF healing was defined as disappearing of anal pain or fissure. From March 2004 to March 2008, 142 patients were treated with Diltiazem 2% three times a day. Telephonic questionnaire in December 2009 regarding anal symptoms, treatment survey, abandonment of Diltiazem, healing rate and surgery was done by non-surgical-residents with at least 1 year treatment.Results:Seventy-two men and 66 women with a mean age of 45 (range: 18-77)presented a CAF. One hundred and fifteen cases were located posteriorly, 21 anteriorly and two were both. Four patients were excluded due to intersphincteric fistula and 33 were lost to follow-up. One hundred and five patients (73.9%) could be interviewed. Sixty-one patients (58.1%) referred no complete improvement. Forty patients out of 105 were operated due to failure of Diltiazem (38.1%). Treatment success dropped to 61.9%. Only 44 (41.9%) patients referred to be healed without surgery.Conclusion:The optimistic results of the first studies could not stand the time (61.9%) and a simple questionnaire evidenced that healing rate is far lower than expected.

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