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

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

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.

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Authors and Affiliations

  1. Çocuk Cerrahisi Anabilim Dali, Harran Universitesi Tip Fakultesi, Morfoloji Binasi, Yenisehir Kampusu, 63300, Sanliurfa, Turkey

    Muazez Cevik, Mehmet Emin Boleken, Servet Ocal, Mehmet Emin Balcioglu & Asim Aydinoglu

  2. Çocuk Cerrahisi Anabilim Dali, Sisli Etfal Egitim ve Arastitma Hastanesi, SEAH Cocuk Cerrahisi ABD, Istanbul, Turkey

    Cetin Ali Karadag

  3. Halk Sagligi Anabilim Dali, Harran Universitesi Tip Fakultesi, Morfoloji Binasi, Yenisehir Kampusu, 63300, Sanliurfa, Turkey

    Ibrahim Koruk

Authors
  1. Muazez Cevik
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  2. Mehmet Emin Boleken
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  3. Ibrahim Koruk
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  4. Servet Ocal
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  5. Mehmet Emin Balcioglu
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  7. Cetin Ali Karadag
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Correspondence to Muazez Cevik.

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Cevik, M., Boleken, M.E., Koruk, I. et al. A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children. Pediatr Surg Int 28, 411–416 (2012). https://doi.org/10.1007/s00383-011-3048-4

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  • DOI: https://doi.org/10.1007/s00383-011-3048-4

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