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Related Experiment Videos

Anal fissure. 20-year experience

C Oh1, C M Divino, R M Steinhagen

  • 1Department of Surgery, Mount Sinai Medical Center, New York, New York, USA.

Diseases of the Colon and Rectum
|April 1, 1995
PubMed
Summary
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Surgical treatment for chronic anal fissures offers over 95% symptom relief. Open lateral internal sphincterotomy is recommended for intractable cases, while hygiene is key for prevention and initial management.

Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Surgical outcomes

Background:

  • Anal fissures are common anorectal conditions.
  • Chronic fissures often require surgical intervention.
  • Understanding etiologic factors is crucial for effective management.

Purpose of the Study:

  • To review a 20-year surgical experience with anal fissure treatment.
  • To identify potential etiologic factors.
  • To explore preventative measures and optimal treatment strategies.

Main Methods:

  • Retrospective review of 1,391 patients (1972-1991) with chronic anal fissures.
  • Surgical procedures included internal sphincterotomy, C-anoplasty, debridement, and sphincter excision.
  • Acute fissures were managed conservatively with emphasis on hygiene.

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Main Results:

  • Conservative management was effective for acute superficial fissures.
  • Over 95% of surgically treated chronic fissures achieved satisfactory symptom relief.
  • Complication rates were higher with closed versus open sphincterotomy.

Conclusions:

  • Anal hygiene is vital for fissure prevention and conservative treatment.
  • Open lateral internal sphincterotomy is the preferred treatment for chronic, intractable fissures.
  • C-anoplasty and sphincter excision are indicated for specific anal canal abnormalities.