Anal Fissure

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video Trainee Video: Laser surgery for anal fistula

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Educational session - Tomas Poskus (Lithuania) at ESCP Dublin 2022

video Core Subject Update: Anal fissure

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Educational session - Gaetano Luglio (Italy) at ESCP Dublin 2022

video ESCP Essentials - Are setons always necessary before Sphincter Preserving Surgery?

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Dr David Zimmerman

video ESCP Essentials – New techniques; what is out there and what is coming in Crohns fistulas?

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Professor Antonino Spinelli

video ESCP Essentials – Fistula closure – Flap or LIFT?

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Dr Christianne Buskens

video ESCP Essentials - What outcomes should we report/use for fistula treatment?

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Dr Andreas Ommer

video ESCP Essentials – Stem cells for perianal fistulas in Crohn’s Disease

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Dr. med. Daniela Cabalzar- Wondberg

video ESCP Essentials - Imaging in perianal fistulas

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Dr Ian White

video ESCP Essentials – Is there a place for fistulotomy in cryptoglandular fistula?

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Janindra Warusivatarne

video ESCP Essentials - Stepwise approach in Crohn’s perianal fistula

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Dr Krisztina Gesce

video ESCP Essentials - Why should stem cells work in treating Crohn’s anal fistula?

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Phil Tozer

video ESCP Essentials - What patients should know

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Richard Brady

document Anal Fissure (Chapter 5, European Manual of Medicine: Coloproctology Second Edition) Popular

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An anal fissure is a tear in the epithelial lining of the anal canal, distal to the dentate line. It is accompanied by a significant increase in the tone of the internal anal sphincter. Anal pain is usually intense, occurs during or minutes after a bowel movement, and can last from minutes to hours. It may be accompanied by minimal bleeding. A fissure is usually located in the posterior (in 90 % of cases) or anterior midline (in 10 % of women and 1–5 % of men with anal fissure). If there are multiple fissures or occur at a lateral position, other anal pathologies must be ruled out (e.g., tuberculosis, syphilis, HIV, Crohn’s disease). Treatment of anal fissure is based on general measures and pharmacological intervention. General measures consist of sitz baths, avoiding the presence of hard stools by using laxatives or significantly increasing fiber intake, and using analgesics. Pharmacological treatment is based on three groups: a nitric oxide donor (glyceryl trinitrate), calcium channel antagonists (diltiazem, nifedipine), and botulinum toxin. The results of these treatments are better than placebo but inferior to surgery. If these treatments fail, surgery is the best option. Sphincterotomy is an outpatient procedure with a success rate greater than 90 %, but it has a postoperative incontinence rate between 3 % and 15 %. A chance of postoperative incontinence is the main reason why drug treatment is now considered as the first therapeutic option, especially in patients with a high risk for incontinence.

video Surgical approach to fissures Popular

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Trainees Video Session - Bruno Roche at ESCP Dublin 2015

video Ultrasound evaluation of fistula and abscess

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Anorectal and Pelvic Ultrasound Course - Carlo Ratto at ESCP Barcelona 2014

video Topical platelet lysate hydrogel in patients with anal fissure: randomized double-blind controlled trial

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Oral Poster (Proctology) - Leila Ghahramani at ESCP Barcelona 2014

video Percutaneous tibial nerve stimulation - PTNS: a novel alternative treatment option for chronic therapy resistant anal fissure

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Oral Poster (Functional disorders) - Louis Johnson at ESCP Barcelona 2014

video Stress, psychopathology and its impact on quality of life in chronic anal fissure (CAF) patients

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Free Paper (Proctology) - Ozden Arisoy at ESCP Barcelona 2014

pdf Proctology: Anal fissure

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Symposium - Alexander Engel (Australia) at Tripartite Colorectal Meeting 2014

video Isosorbide dinitrate ointment versus botulinum toxin A (Dysport®) as primary treatment for chronic anal fissure: a randomized multicenter study

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Free paper - A.E.M. Berkel at ESCP Belgrade 2013

video An interesting first line treatment in anal fissures: the injection of a sclerosing agent

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Oral poster - Michael Dessily at ESCP Belgrade 2013

video Results of the extent of lateral internal sphincterotomy for the treatment of chronic anal fissure. A three-dimensional endosonogaphic study

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Oral poster - Stephanie Garcia-Botello at ESCP Vienna 2012

video Topical diltiazem ointment versus botulinum toxin A for the treatment of chronic anal fissure: a double-blind randomized clinical trial

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Free paper - Bas Twigt at ESCP Sorrento 2010

video An open label study to examine the effect of coated Nifedipine suppositories on anal pressure in healthy subjects

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Oral poster - Michael Shapiro at ESCP Sorrento 2010

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