Abstract：
:Chronic anal fissure is a common benign anorectal problem in Western countries that substantially impairs the patient's life. Consequently, a rapid and effective solution is required. We reviewed the various treatments for chronic anal fissure described in the literature, with the aim of establishing a therapeutic protocol. We recommend surgical sphincterotomy (preferably open or closed lateral sphincterotomy) as the first therapeutic approach in patients with chronic anal fissure. However, we prefer the use of chemical sphincterotomy (preferably botulinum toxin) in patients aged more than 50 years old and in those with previous incontinence, risk factors for incontinence (previous anal surgery, multiple vaginal births, diabetes, inflammatory bowel disease, etc.), or without anal hypertonia, despite the higher recurrence rate with medical treatments, since this procedure avoids the greater risk of residual incontinence described in the literature with surgical sphincterotomy in this group of patients.
journal_name
Cir Espjournal_title
Cirugia espanolaauthors
Arroyo A,Pérez-Vicente F,Serrano P,Candela F,Sánchez A,Pérez-Vázquez MT,Calpena Rdoi
10.1016/s0009-739x(05)70893-9subject
Has Abstractpub_date
2005-08-01 00:00:00pages
68-74issue
2eissn
0009-739Xissn
1578-147Xpii
13077503journal_volume
78pub_type
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