Abstract
DR. MICHAEL VALENTE (Cleveland, Ohio): This is a well-done retrospective review looking at potential predictors of success of nonoperative treatment with botulinum toxin. I have a few questions for clarification. What predicts successful nonoperative management with botulinum toxin for anal fissure?The American Journal of SurgeryVol. 219Issue 3PreviewThis is a retrospective study looking at predictors of successful non-operative management of anal fissures using botulinum toxin. We demonstrated that 60% of patients have responded to injection and 26% ultimately underwent subsequent surgery. We have shown that male sex index is associated with a decreased response to injection and higher likelihood of future surgery, and similar to previous studies patient satisfaction at the first follow up procedure was a good predictor of future success. Full-Text PDF
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