[Treatment of chronic anal fissure with botulinic toxin type A].
Anal fissure is a disease that generally affects to young people, but it can present at any age.


OBJECTIVE
To show our experience in the treatment of chronic anal fissure with botulinum toxin type A.


METHODS
This is a prospective, experimental and longitudinal study realized in the Coloproctology Unit in the General Hospital of Mexico City and in Medical North of Monterrey, Mexico, between June 2002 and November 2004. Direct variable was healing with 25 units of botulinum toxin. Secondary variables: age, sex, symptomatology, evolution time, localization of fissure, evolution after application of botulinum toxin, complications and time ofhealing.


RESULTS
35 (67.30%) were female and 17 (32.69%), male; age range, 21 to 64 years, with a medium of 43. At twelve months of toxin, application of 34 (65.38%) patients were asymptomatic, but in four fissure persisted. The other 18 patients were operated on due to persistence of the fissure. In a follow up of 18 months, 30 patients cured (57.69%), 4 improved (7.69%) and 18 (34.61%) were failures; one died by myocardial infarction and there were no recurrences.


CONCLUSIONS
Botulinum toxin type A is a good alternative in the treatment of chronic anal fissure. Healing or improved with the application of 25 units of botulinum toxin was 65.38%.
Unidad de Coloproctología del Servicio de Gastroenterología del Hospital General de México, México, DF. luischarua@hotmail.com
Luis
L
Charúa Guindic
Evangelina
E
Fonseca Muñoz
Luis Roberto
LR
Guerra Melgar
Octavio
O
Avendaño Espinosa
Norberto Joel
NJ
García Pérez
Elías
E
Charúa Levy
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A