Anal fissure: Surgical management

Abstract

An anal fissure is a tear or ulceration in the lining of the anal canal below the mucocutaneous junction. Medical treatment cures an anal fissure typical in most patients. Because sphincter preservation is important for patients who often have chronic diarrhea, fissures in Crohn's patients are usually treated medically rather than surgically. A lateral sphincterotomy is reserved for Crohn's patients with minimal active anorectal inflammation who fail all available non-surgical therapies. Medical treatment is often used as an initial treatment of an anal fissure. Surgery is reserved for patients in whom medical treatment fails. The technique will depend on the patient and the type and temporality of the fissure according to the different authors. The choice of technique should be based on the individual characteristics of the patients to reduce complications as much as possible.