María F. Adjounian, Servicio de Cirugía General III, Universidad Central de Venezuela, Caracas, Venezuela
Luis A. Salazar, Servicio de Urología, Universidad Central de Venezuela, Caracas, Venezuela
Adrián Terán-Cardoza, Servicio de Cirugía General III, Universidad Central de Venezuela, Caracas, Venezuela
Victoria Correa-Robayo, Servicio de Anestesiología, Universidad Central de Venezuela, Caracas, Venezuela
Ángel Navia-Padilla, Médico Servicio Cirugía, Universidad Central de Venezuela, Caracas, Venezuela
Christopher Varela, Servicio de Cirugía General III, Universidad Central de Venezuela, Caracas, Venezuela
Objective: To compare the topical treatment of diltiazem vs. isosorbide dinitrate in acute anal fissures. Methods: Descriptive, prospective, single-blind, randomized study. The population was constituted by patients who attended the Coloproctology Service consultation in Hospital Domingo Luciani at Caracas, Venezuela, period March-October 2022. Sampling was census- type, including patients with diagnosis of anal fissure. Results: Thirty patients were assessed, average age of 42.0 ± 13.0 years, 50% were females, 42.0% had a history of hemorrhoidal disease. Pain intensity was greater in the isosorbide dinitrate group, being intense in 80%. However, in the diltiazem group, 60% was moderate (p = 0.06). All patients treated with diltiazem healed the acute anal fissure. On the other hand, patients in the isosorbide dinitrate group had 71.6% healing, and 33.3% did not heal and underwent surgery (p = 0.03). The healing time in both groups was 4 weeks of treatment for 53.0%, without statistically significant differences (p = 0.44). Side effects: headache (33.3% with diltiazem), skin rash (6.7% with isosorbide dinitrate), this difference being statistically significant. Conclusions: Healing and pain intensity of the acute anal fissure were comparable in both groups. However, diltiazem evidenced a higher rate of healing and headaches associated to its use.
Keywords: Acute anal fissure. Topical diltiazem. Isosorbide dinitrate. Anal pain.
