{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:24:07Z","timestamp":1787955847478,"version":"build-2784847793"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2007,1,29]],"date-time":"2007-01-29T00:00:00Z","timestamp":1170028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In recent years treatment of chronic anal fissure has shifted from surgical to medical. This study compared the ability of two non-surgical treatments\u2014botulinum toxin injections and nitroglycerin ointment\u2014to induce healing in patients with idiopathic anal fissure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One hundred adults were assigned randomly to receive treatment with either type A botulinum toxin (30 units Botox\u00ae or 90 units Dysport\u00ae) injected into the internal anal sphincter or 0\u00b72 per cent nitroglycerin ointment applied three times daily for 8 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After 2 months, the fissures were healed in 46 (92 per cent) of 50 patients in the botulinum toxin group and in 35 (70 per cent) of 50 in the nitroglycerin group (P = 0\u00b7009). Three patients in the botulinum toxin group and 17 in the nitroglycerin group reported adverse effects (P &amp;lt; 0\u00b7001). Those treated with botulinum toxin had mild incontinence to flatus that lasted 3 weeks after treatment but disappeared spontaneously, whereas nitroglycerin treatment was associated with transient, moderate-to-severe headaches. Nineteen patients who did not have a response to the assigned treatment crossed over to the other therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective option.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.5514","type":"journal-article","created":{"date-parts":[[2007,1,29]],"date-time":"2007-01-29T12:44:41Z","timestamp":1170074681000},"page":"162-167","source":"Crossref","is-referenced-by-count":87,"title":["Randomized clinical trial comparing botulinum toxin injections with 0\u00b72 per cent nitroglycerin ointment for chronic anal fissure"],"prefix":"10.1093","volume":"94","author":[{"given":"G","family":"Brisinda","sequence":"first","affiliation":[{"name":"Department of Surgery, 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Surgery, Catholic University Hospital Agostino Gemelli, Istituto di Clinica Chirurgica Generale, Policlinico Universitario Agostino Gemelli, Largo Agostino Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Maria","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catholic University Hospital Agostino Gemelli, Istituto di Clinica Chirurgica Generale, Policlinico Universitario Agostino Gemelli, Largo Agostino Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2007,1,29]]},"reference":[{"key":"2021070911055496200_bib1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/bjs.4531","article-title":"Chronic anal fissure","volume":"91","author":"Lindsey","year":"2004","journal-title":"Br J 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