[Current data on fissures and their treatment]

A review of the literature published during the last few years concerning the pathogenesis, clinics and treatment of anal fissures does not supply any new elements in the concept of the triggering of the fissure and its passage to chronicity. If the acute form hardly raises any diagnostic problems, the "chronic or non-cicatrized" form has to be distinguished from the anal localizations of certain general disorders such as Crohn's disease, certain cancers... Medical treatment does not cure the fissural disease. In the young, uncomplicated fissure, most cases can be cured with one or two injections of xylocaine or the double chlorhydrate of quinine and urea. However, if the fissure is old, other methods are required. Cryotherapy alone is effective. Digital or instrumental dilatation creates an uncontrolled leyomyotomia. It is rarely used and has certain disadvantages. Most proctologists resort to surgical methods: open or lateral or posterior blind sub-mucous leiomyotomia produces muscle relaxation, therefore, a reduction in pain and cicatrization of the fissure, or fissurectomy alone associated with leiomyotomia and anoplasty. The choice of technique depends more on each person's habits rather than on the more favorable results obtained with one of the methods.