대한대장항문학회

Purpose: This study was designed to compare the effect of treatment using glyceryl trinitrate (GTN) ointment with that of conservative treatment (CT) on chronic anal fissure. Methods: As a preliminary study, maximal resting pressures of the anal<br>canal<br>were checked in 13 patients having chronic anal fissure before and 10 minutes after application of 0.2% GTN ointment. As the study groups, 59 patients having chronic anal fissure were randomly allocated to the GTN and the placebo groups. All the<br>patients in both groups were given oral analgesics, sedatives, and bulk-forming agents. They had applied 0.2% GTN ointment or a placebo ointment three times a day to their perianal skin.<br>Maximal resting pressures of the anal canal were checked at the beginning and at the endpoint of the treatment period which continued for 6 weeks. If there was complete healing of the fissure in the middle of the treatment, the treatment was<br>stopped.<br>Sixteen patients were lost during the study. Results: Among the rest, 22 and 21 patients were included in the GTN group and the placebo group, respectively. The maximal resting pressure decreased significantly in all groups (p＜0.05). The healing<br>rates,<br>the recurrence rates, and the operation rates were not significantly different between the GTN group and placebo group (p＞0.05). Conclusion: The effect of GTN on the symptomatic relief and results of treatment in patients having chronic anal<br>fissure is<br>not superior to that of conservative treatment.<br>