<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7493</journal-id>
<journal-title><![CDATA[Revista Cubana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Cir]]></abbrev-journal-title>
<issn>0034-7493</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-74932022000100002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Esfinterotomía lateral interna vs. toxina botulínica como tratamiento de la fisura anal]]></article-title>
<article-title xml:lang="en"><![CDATA[Lateral Internal Sphincterotomy versus Botulinum Toxin as Treatment of Anal Fissure]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín Pérez]]></surname>
<given-names><![CDATA[Alfredo Lázaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Toledo Santana]]></surname>
<given-names><![CDATA[Nancy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cedeño Carreño]]></surname>
<given-names><![CDATA[Franklyn Rogelio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín Hernández]]></surname>
<given-names><![CDATA[Alymays]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez Fernández]]></surname>
<given-names><![CDATA[Juan Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín Toledo]]></surname>
<given-names><![CDATA[Ilien Alnay]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Técnica de Manabí  ]]></institution>
<addr-line><![CDATA[ Manabí]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital &#8220;Dr. Verdi Cevallos Balda&#8221;  ]]></institution>
<addr-line><![CDATA[ Manabí]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Ciencias Médicas de La Habana Hospital Universitario &#8220;Miguel Enríquez&#8221; ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital IESS  ]]></institution>
<addr-line><![CDATA[ Manta]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>61</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-74932022000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-74932022000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-74932022000100002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La fisura anal crónica es una entidad frecuente que produce molestias durante y después de la defecación, su fisiopatología no es clara y su manejo es variado. La esfinterotomia lateral interna es una de las técnicas más utilizadas, aunque su elevado porcentaje de incontinencia no es aceptado y la inyección de toxina botulínica es una alternativa tentadora.  Objetivo:  Comparar los resultados de la inyección de toxina botulínica tipo A con la esfinterotomia lateral interna para tratamiento de la fisura anal en cuanto a dolor postoperatorio, recurrencia, curabilidad e incontinencia.  Métodos:  Se realizó un estudio tipo cohorte. A un grupo de 40 pacientes se trató con inyección de 50 UI de Toxina Botulínica tipo A y el otro grupo de 42 pacientes se le realizó esfinterotomia lateral interna. Los resultados se comparan estadísticamente para CI95 y error de 0,05.  Resultados:  La esfinterotomia vs toxina botulínica, resultó en cuanto a curabilidad en un 85,4 % de los casos contra un 77,5 %. Las recidivas se presentaron en 4,8 % / 12,5 %, la incontinencia ocurrió en 9,5 % / 2,5 % y el dolor posoperatorio estuvo presente en el 14,8 % / 5,0 %.  Conclusiones:  La esfinterotomia resultó mejor en cuanto a curabilidad y recidivas, mientras la aplicación de la toxina botulínica presentó mejores resultados en la incontinencia fecal y el dolor posoperatorio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Chronic anal fissure is a frequent entity that produces discomfort during and after defecation. Its pathophysiology is not clear and its management is varied. Lateral internal sphincterotomy is one of the most used techniques, although its high percentage of incontinence is not accepted; botulinum toxin injection is therefore a tempting alternative.  Objective: To compare the results of botulinum toxin type A injection or lateral internal sphincterotomy for treatment of anal fissure in terms of postoperative pain, recurrence, healing and incontinence.  Methods:  A cohort study was carried out. One group of 40 patients were treated with injection of 50 IU of botulinum toxin type A and another group of 42 patients underwent lateral internal sphincterotomy. The results were statistically compared with a confidence interval of 95% and error of 0.05.  Results: Sphincterotomy and botulinum toxin were effective in terms of healing in 85.4% and 77.5% of cases, respectively. Recurrences occurred in 4.8% and 12.5% of cases, respectively. Incontinence occurred in 9.5% and 2.5% of cases, respectively. Postoperative pain was present in 14.8% and 5.0% of cases, respectively.  Conclusions: Sphincterotomy was better in terms of healing and recurrence, while botulinum toxin application showed better results regarding fecal incontinence and postoperative pain.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[fisura anal]]></kwd>
<kwd lng="es"><![CDATA[esfinterotomía lateral interna]]></kwd>
<kwd lng="es"><![CDATA[toxina botulínica]]></kwd>
<kwd lng="en"><![CDATA[anal fissure]]></kwd>
<kwd lng="en"><![CDATA[internal lateral sphincterotomy]]></kwd>
<kwd lng="en"><![CDATA[botulinum toxin]]></kwd>
</kwd-group>
</article-meta>
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