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


CONCLUSIONS
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.
Çocuk Cerrahisi Anabilim Dali, Harran Universitesi Tip Fakultesi, Morfoloji Binasi, Yenisehir Kampusu, 63300, Sanliurfa, Turkey. cevikmuazzez@gmail.com
Muazez
M
Cevik
Mehmet Emin
ME
Boleken
Ibrahim
I
Koruk
Servet
S
Ocal
Mehmet Emin
ME
Balcioglu
Asim
A
Aydinoglu
Cetin Ali
CA
Karadag
D000779:Anesthetics, Local / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004110:Diltiazem / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D005996:Nitroglycerin / Q000627:therapeutic use*; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000779:Anesthetics, Local; D014665:Vasodilator Agents; D008012:Lidocaine; D004110:Diltiazem; D005996:Nitroglycerin