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Updated: Aug 16, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Glyceryl trinitrate vs. sphincterotomy for treatment of chronic fissure-in-ano: a randomized, controlled trial
1Department of Surgery, JG Strijdom Hospital and the University of the Witwatersrand, Johannesburg, South Africa.
Purpose:
This study was undertaken to compare local application of a glyceryl trinitrate ointment with lateral internal sphincterotomy for the treatment of chronic fissure-in-ano.
Patients And Methods:
A sample of 24 consecutive patients with chronic anal fissure was randomly allocated to treatment with sphincterotomy or local glyceryl trinitrate. Patients were followed-up for a median of 22 months.
Results:
All 12 patients healed following sphincterotomy; 10 of 12 healed with local glyceryl trinitrate (P = 0.239). There were no recurrences or side-effects in either group.
Conclusions:
Local application of glyceryl trinitrate can avoid surgery in more than 80 percent of patients with chronic anal fissure.

