Surgical treatment of chronic anal fissure

This is a retrospective study of 1753 cases of chronic anal fissures treated by five varying methods over a five-year period from January 1976 to December 1980. Results showed that the incidence of recurrent fissures was higher in those treated by anal fissurectomy with sphincterotomy. There was also a significant difference in operative time, length of hospital stay, patient discomfort, and incidence of urinary retention among these operative methods. Generally, lateral anal sphincterotomy and multiple anal sphincterotomies showed a lesser incidence of these factors. A simpler procedure, such as lateral anal shipncterotomy or multiple anal sphincterotomies, is the treatment of choice for chronic anal fissure. However, a chronic anal fissure associated with symptomatic enlarged hemorrhoids may have a similar result when treated with hemorrhoidectomy and fissurectomy as a combined procedure. Read at the meeting of the American Society of Colon and Rectal Surgeons, Boston, Massachusetts, June 5 to 9, 1983.