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[Current data on fissures and their treatment].

J Nora

    Annales De Gastroenterologie Et D'Hepatologie
    |November 1, 1986
    PubMed
    Summary

    Anal fissures require specific treatments, with medical options limited to acute cases. Chronic anal fissures often necessitate surgical interventions like lateral internal sphincterotomy for effective healing and pain relief.

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    Differential diagnosis of carcinoma of the anal margin.

    Proceedings of the Royal Society of Medicine·1968

    Area of Science:

    • Gastroenterology
    • Colorectal Surgery

    Context:

    • Anal fissures are common anorectal conditions with established pathogenesis.
    • Distinguishing chronic anal fissures from other conditions like Crohn's disease or anal cancers is crucial for accurate diagnosis.

    Purpose:

    • To review the current literature on the pathogenesis, clinical presentation, and treatment of anal fissures.
    • To evaluate the efficacy of various treatment modalities for acute and chronic anal fissures.

    Summary:

    • Medical treatments are generally ineffective for chronic anal fissures.
    • While injections of xylocaine or quinine-urea/urea hydrochloride can treat uncomplicated acute fissures, older or chronic fissures require alternative approaches.
    • Effective treatments for chronic anal fissures include cryotherapy, lateral internal sphincterotomy (open or closed), and fissurectomy with anoplasty, with technique selection often based on surgeon preference.

    Impact:

    • Highlights the limitations of medical management for chronic anal fissures.
    • Underscores the importance of surgical interventions for achieving fissure healing and symptom resolution.
    • Suggests that current treatment choices for chronic anal fissures are often based on individual surgeon experience rather than definitive outcome data.

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