Pediatric Surgery International

, Volume 28, Issue 4, pp 411–416 | Cite as

A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children

  • Muazez CevikEmail author
  • Mehmet Emin Boleken
  • Ibrahim Koruk
  • Servet Ocal
  • Mehmet Emin Balcioglu
  • Asim Aydinoglu
  • Cetin Ali Karadag
Original Article



Anal fissure (AF) is a common perianal condition in children. Although adult patients with AF have been treated successfully using diltiazem, it has not been studied in children. The present randomized, prospective, double-blind study assessed the response, side effects, and recurrence of diltiazem.


Ninety-three children with AF were randomly divided into three groups. Each group received topical ointment. Group GTN received 0.2% glyceryl trinitrate, group L received 10% lidocaine, and group D received 2% diltiazem ointment.


Eighty-two patients completed the 12-month study. At the end of the first 8-week course, the healing rate in group D was significantly higher than that of the other groups (p < 0.0001, χ 2 = 19.82). Nonresponders received a second course of the same treatment. Group D showed significantly higher healing rates than the other groups (p < 0.05, χ 2 = 7.227) at the end of the second 8-week course. The group D recurrence rate was significantly different than that of the other groups (p < 0. 002, χ 2  = 12.79).


Diltiazem application is effective and safe for the treatment of AF in children, and has a low recurrence rate. The smooth dose–concentration curve causes minimal side effects.


Anal fissure Children Diltiazem Glyceryl trinitrate Lidocaine 


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Muazez Cevik
    • 1
    Email author
  • Mehmet Emin Boleken
    • 1
  • Ibrahim Koruk
    • 3
  • Servet Ocal
    • 1
  • Mehmet Emin Balcioglu
    • 1
  • Asim Aydinoglu
    • 1
  • Cetin Ali Karadag
    • 2
  1. 1.Çocuk Cerrahisi Anabilim DaliHarran Universitesi Tip FakultesiSanliurfaTurkey
  2. 2.Çocuk Cerrahisi Anabilim DaliSisli Etfal Egitim ve Arastitma HastanesiIstanbulTurkey
  3. 3.Halk Sagligi Anabilim DaliHarran Universitesi Tip FakultesiSanliurfaTurkey

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