The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure
Abstract Introduction The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-02223-z |
| _version_ | 1797454064659726336 |
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| author | Antonio Brillantino Adolfo Renzi Pasquale Talento Francesca Iacobellis Luigi Brusciano Luigi Monaco Domenico Izzo Alfredo Giordano Michele Pinto Corrado Fantini Marcello Gasparrini Michele Schiano Di Visconte Francesca Milazzo Giovanni Ferreri Andrea Braini Umberto Cocozza Massimo Pezzatini Valeria Gianfreda Alberto Di Leo Vincenzo Landolfi Umberto Favetta Sergio Agradi Giovanni Marino Massimilano Varriale Massimo Mongardini Claudio Eduardo Fernando Antonio Pagano Riccardo Brachet Contul Nando Gallese Giampiero Ucchino Michele D’Ambra Roberto Rizzato Giacomo Sarzo Bruno Masci Francesca Da Pozzo Simona Ascanelli Fabrizio Foroni Alessio Palumbo Patrizia Liguori Angela Pezzolla Luigi Marano Antonio Capomagi Eugenio Cudazzo Francesca Babic Carmelo Geremia Alessandro Bussotti Mario Cicconi Antonia Di Sarno Federico Maria Mongardini Antonio Brescia Leonardo Lenisa Massimiliano Mistrangelo Maria Laura Sandoval Sotelo Luciano Vicenzo Antonio Longo Ludovico Docimo |
| author_facet | Antonio Brillantino Adolfo Renzi Pasquale Talento Francesca Iacobellis Luigi Brusciano Luigi Monaco Domenico Izzo Alfredo Giordano Michele Pinto Corrado Fantini Marcello Gasparrini Michele Schiano Di Visconte Francesca Milazzo Giovanni Ferreri Andrea Braini Umberto Cocozza Massimo Pezzatini Valeria Gianfreda Alberto Di Leo Vincenzo Landolfi Umberto Favetta Sergio Agradi Giovanni Marino Massimilano Varriale Massimo Mongardini Claudio Eduardo Fernando Antonio Pagano Riccardo Brachet Contul Nando Gallese Giampiero Ucchino Michele D’Ambra Roberto Rizzato Giacomo Sarzo Bruno Masci Francesca Da Pozzo Simona Ascanelli Fabrizio Foroni Alessio Palumbo Patrizia Liguori Angela Pezzolla Luigi Marano Antonio Capomagi Eugenio Cudazzo Francesca Babic Carmelo Geremia Alessandro Bussotti Mario Cicconi Antonia Di Sarno Federico Maria Mongardini Antonio Brescia Leonardo Lenisa Massimiliano Mistrangelo Maria Laura Sandoval Sotelo Luciano Vicenzo Antonio Longo Ludovico Docimo |
| author_sort | Antonio Brillantino |
| collection | DOAJ |
| description | Abstract Introduction The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. Methods A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. Conclusions In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry. |
| first_indexed | 2024-03-09T15:31:52Z |
| format | Article |
| id | doaj.art-1e173aaaf91e4ae9a13315dc6f327e49 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T15:31:52Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-1e173aaaf91e4ae9a13315dc6f327e492023-11-26T12:11:31ZengBMCBMC Surgery1471-24822023-10-0123111910.1186/s12893-023-02223-zThe Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissureAntonio Brillantino0Adolfo Renzi1Pasquale Talento2Francesca Iacobellis3Luigi Brusciano4Luigi Monaco5Domenico Izzo6Alfredo Giordano7Michele Pinto8Corrado Fantini9Marcello Gasparrini10Michele Schiano Di Visconte11Francesca Milazzo12Giovanni Ferreri13Andrea Braini14Umberto Cocozza15Massimo Pezzatini16Valeria Gianfreda17Alberto Di Leo18Vincenzo Landolfi19Umberto Favetta20Sergio Agradi21Giovanni Marino22Massimilano Varriale23Massimo Mongardini24Claudio Eduardo Fernando Antonio Pagano25Riccardo Brachet Contul26Nando Gallese27Giampiero Ucchino28Michele D’Ambra29Roberto Rizzato30Giacomo Sarzo31Bruno Masci32Francesca Da Pozzo33Simona Ascanelli34Fabrizio Foroni35Alessio Palumbo36Patrizia Liguori37Angela Pezzolla38Luigi Marano39Antonio Capomagi40Eugenio Cudazzo41Francesca Babic42Carmelo Geremia43Alessandro Bussotti44Mario Cicconi45Antonia Di Sarno46Federico Maria Mongardini47Antonio Brescia48Leonardo Lenisa49Massimiliano Mistrangelo50Maria Laura Sandoval Sotelo51Luciano Vicenzo52Antonio Longo53Ludovico Docimo54Deparment of Surgery, “A. Cardarelli” Hospital“Buonconsiglio-Fatebenefratelli” HospitalDepartment of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio EmiliaDepartment of General and Emergency Radiology, “A. Cardarelli” HospitalDepartment of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”“Pineta Grande” Hospital, “Villa Esther” ClinicDepartment of General and Emergency Surgery, AORN dei Colli Monaldi-Cotugno-CTO, CTO HospitalDepartment of General and Emergency Surgery, University of Salerno, Hospital of Mercato San SeverinoHumanitas CastelliDepartment of Surgery, “Dei Pellegrini” Hospital, ASL Napoli 1Oncologic Colorectal Unit, “Sant’Andrea” University HospitalDepartment of General Surgery, Colorectal and Pelvic Floor Diseases Center, “Santa Maria Dei Battuti” HospitalDepartment of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio EmiliaDepartment of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio EmiliaDepartment of General Surgery, Azienda Sanitaria Friuli Occidentale (ASFO)Department of General Surgery, “S. Maria Degli Angeli” Hospital“Dei Castelli” Hospital, ASL Roma 6Unit of Colonproctologic and Pelvic Surgery, “M.G. Vannini” HospitalDepartment of General and Minivasive Surgery, “San Camillo” HospitalDepartment of General and Specalist Surgery, AORN “S.G. Moscati”Unit of Proctology and Pelvic Surgery, “Città di Pavia” ClinicHumanitas Gavazzeni/Castelli BergamoDepartment of General Surgery, “Santa Marta e Santa Venera” Hospital of AcirealeDepartment of General and Emergency Surgery, “Sandro Pertini” Hospital, Asl Roma 2“La Sapienza” University of Rome, “Umberto1” PolyclinicUnit of Proctology and Pelvic Surgery, “Città di Pavia” ClinicGeneral Ad Urgent Surgery, “U. Parini” Regional HospitalUnit of Proctologic Surgery, “Sant’Antonio” ClinicUnit of General Surgery, “Maggiore” HospitalDepartment of General and Oncologic-Minivasive Surgery, “Federico II” UniversityDepartment of General Surgery, Hospital of Conegliano AULSS 2Department of General Surgery, University of Padova, “Sant’Antonio” Hospital“San Carlo di Nancy” HospitalDepartment of Surgery, “Santa Maria dei battuti” Hospital, San Vito al TagliamentoDepartment of Surgery, University Hospital of FerraraDeparment of Surgery, “A. Cardarelli” HospitalDeparment of Surgery, “A. Cardarelli” HospitalDepartment of Surgery, “Mater Dei” HospitalDepartment of Surgery, University Aldo MoroAcademy of Applied Medical and Social Sciences - AMiSNS: Akademia Medycznych i Spolecznych Nauk Stosowanych“Montanari” Hospital, Morciano di RomagnaDepartment of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio EmiliaDepartment of Surgery, Hospital of Cattinara, ASUGI TriesteUnit of Proctology and Pelvic Surgery, “Città di Pavia” Clinic“San Carlo Di Nancy” HospitalDepartment of General Surgery, “Sant’Omero-Val Vibrata” Hospital“Buonconsiglio-Fatebenefratelli” HospitalDepartment of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”Department of Oncologic Colorectal Surgery, University Hospital S. Andrea, “La Sapienza” UniversityDepartment of Surgery, Humanitas San Pio X, Surgery Unit, Pelvic Floor CentreDepartment of Surgery, “Le Molinette” HospitalDeparment of Surgery, “A. Cardarelli” HospitalDeparment of Surgery, “A. Cardarelli” Hospital“Madonna Della Fiducia” ClinicDepartment of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”Abstract Introduction The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. Methods A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. Conclusions In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry.https://doi.org/10.1186/s12893-023-02223-zAnal fissureAnal spasmEndoanal ultrasoundAnal manometryAnal dilatationSphincterotomy |
| spellingShingle | Antonio Brillantino Adolfo Renzi Pasquale Talento Francesca Iacobellis Luigi Brusciano Luigi Monaco Domenico Izzo Alfredo Giordano Michele Pinto Corrado Fantini Marcello Gasparrini Michele Schiano Di Visconte Francesca Milazzo Giovanni Ferreri Andrea Braini Umberto Cocozza Massimo Pezzatini Valeria Gianfreda Alberto Di Leo Vincenzo Landolfi Umberto Favetta Sergio Agradi Giovanni Marino Massimilano Varriale Massimo Mongardini Claudio Eduardo Fernando Antonio Pagano Riccardo Brachet Contul Nando Gallese Giampiero Ucchino Michele D’Ambra Roberto Rizzato Giacomo Sarzo Bruno Masci Francesca Da Pozzo Simona Ascanelli Fabrizio Foroni Alessio Palumbo Patrizia Liguori Angela Pezzolla Luigi Marano Antonio Capomagi Eugenio Cudazzo Francesca Babic Carmelo Geremia Alessandro Bussotti Mario Cicconi Antonia Di Sarno Federico Maria Mongardini Antonio Brescia Leonardo Lenisa Massimiliano Mistrangelo Maria Laura Sandoval Sotelo Luciano Vicenzo Antonio Longo Ludovico Docimo The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure BMC Surgery Anal fissure Anal spasm Endoanal ultrasound Anal manometry Anal dilatation Sphincterotomy |
| title | The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure |
| title_full | The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure |
| title_fullStr | The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure |
| title_full_unstemmed | The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure |
| title_short | The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure |
| title_sort | italian unitary society of colon proctology siucp societa italiana unitaria di colonproctologia guidelines for the management of anal fissure |
| topic | Anal fissure Anal spasm Endoanal ultrasound Anal manometry Anal dilatation Sphincterotomy |
| url | https://doi.org/10.1186/s12893-023-02223-z |
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