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ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2007, Number 2

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Cir Gen 2007; 29 (2)

Anal fissure

Charúa GL

Language: Spanish
References: 70
Page: 149-158
PDF size: 190.83 Kb.


ABSTRACT

Objective: To present the advances in the knowledge and treatment of anal fissure. To understand its classification, symptomatology, medical treatment, pharmacological treatment, and surgical alternatives.
Design: Bibliographic review.
Material and methods: Medline, Pubmed, Cochrane, EMBASE, Medigraphic databases were searched under the keyword “anal fissure”. Systematic reviews, original research articles, and management guidelines were included in the review.
Results: The standard management to cure the chronic anal fissure has been partial internal lateral sphincterotomy; however, the postoperative pain, the hospitalization costs, the time of working incapacity, and particularly the possibility of fecal incontinence have promoted the development of medication to avoid these inconveniences. Among these medications, topic nitrates, calcium channel blockers, and botulinic toxin type A stand out. The anal fissure with mild to severe symptoms should be managed with any of the aforementioned pharmacological alternatives, especially with botulinic toxin, which has consistently demonstrated the best results. The very symptomatic anal fissure, or with chronicity characteristics, is to be considered for surgical treatment from the time of its diagnosis.
Conclusion: The gold standard for the management of the very symptomatic chronic anal fissure is still the partial internal lateral sphincterotomy.


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