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Updated: Sep 15, 2025
05:39
Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery
Published on: June 23, 2023
1.6K
[Chronic anal fissure-Cremes or surgery?]
Marie Klein1, Marcel Zadnikar1, Lukas Marti2,3
1Klinik für Chirurgie, Kantonsspital St. Gallen, Rorschacherstr. 95, 9007 St. Gallen, Schweiz.
Chirurgie (Heidelberg, Germany)
|July 18, 2025
Summary
Chronic anal fissures are painful anal canal lesions. Surgical treatment, particularly lateral internal sphincterotomy, offers higher success rates (>90%) than conservative medical treatments for anal fissure healing.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Context:
- Anal fissures are painful lesions of the anal canal.
- Acute fissures often heal spontaneously with conservative management.
- Chronic anal fissure treatment recommendations are inconsistent across international guidelines.
Purpose:
- To evaluate the efficacy of different treatment modalities for chronic anal fissures.
- To compare conservative (medical) and surgical interventions for chronic anal fissures.
Summary:
- Conservative treatment using sphincter-relaxing drugs (calcium channel antagonists, nitrates, botulinum toxin) achieves healing in approximately 50% of patients, with prolonged healing times and high recurrence rates.
- Surgical treatment, specifically lateral internal sphincterotomy, demonstrates superior effectiveness with success rates exceeding 90%.
- Fissurectomy, with an 80% success rate, is favored in German-speaking regions due to a lower risk of incontinence compared to other surgical options.
Impact:
- Highlights the limitations of current conservative treatments for chronic anal fissures.
- Establishes lateral internal sphincterotomy as a highly effective surgical option for chronic anal fissures.
- Informs clinical practice regarding the choice of treatment for chronic anal fissures, considering efficacy and incontinence risk.
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