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Abstract

An anal fissure is a painful linearly or elliptically shaped ulceration situated in the lower part of the anal canal extending from the dentate line more or less to the anal verge. This lesion is very common and results in severe pain.

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References

  1. Abcarian H (1980) Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs fissurec-tomy-midline sphincterotomy. Dis Colon Rectum 23:31–36

    Article  CAS  PubMed  Google Scholar 

  2. Arabi Y, Alexander-Williams J, Keighley MRB (1977) Anal pressures in hemorrhoids and anal fissure. Am J Surg 134:608–610

    Article  CAS  PubMed  Google Scholar 

  3. Arnous J, Denis J (1969) Les bases anatomiques et patho-geniques du traitement des fissures anales. Rev Prat 19:1811–1818

    Google Scholar 

  4. Bensaude A (1972) La fissure anale. Rev Prat 22:1779

    CAS  PubMed  Google Scholar 

  5. Boulos PB, Araujo JO (1984) Adequate internal sphincterotomy for chronic anal fissure: subcutaneous or open technique? Br J Surg 71:360–362

    Article  CAS  PubMed  Google Scholar 

  6. Boyer A (1818) Remarques et observations sur quelques maladies de l’anus. J Complement Dictionnaire Sci Med 2:24

    Google Scholar 

  7. Collopy B, Ryan P (1979) Comparison of lateral subcutaneous sphincterotomy with anal dilatation in the treatment of fissure in ano. Med J Aust 2:461–495

    CAS  PubMed  Google Scholar 

  8. Crapp AR, Alexander-Williams J (1975) Fissure-inano and anal sclerosis. Clin Gastroenterol 4:619–628

    CAS  PubMed  Google Scholar 

  9. Duhamel J, Hueber D (1978) Nouvelles etudes statistiques portant sur 500 cas de fissures anales. Ann Gastroenterol Hepatol (Paris) 14:35–39

    Google Scholar 

  10. Duthie HL, Bennett RC (1964) Anal sphincter pressure in fissure-in-ano. Surg Gynecol Obstet 118:19–21

    Google Scholar 

  11. Eisenhammer S (1951) The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 25:2486–2489

    Google Scholar 

  12. Eisenhammer S (1959) The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure. Surg Gynecol Obstet 109:583–590

    CAS  PubMed  Google Scholar 

  13. Fischer M, Thermann M, Trobisch M, Sturm R, Hamelmann H (1976) Die Behandlung der primar-chronischen Analfis-sur durch Dehnung des Analkanals oder Sphincterotomie. Langenbecks Arch Chir 343:35–44

    Article  CAS  PubMed  Google Scholar 

  14. Gabriel WB (1929) Treatment of pruritus ani and anal fissures; the use of anaesthetic solutions in oil. Br Med J 1:1070–1072

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Gabriel WB (1948) Principles and practice of rectal surgery, 4th edn. Lewis, London

    Google Scholar 

  16. Gatehouse D, Arabi Y, Keighley MRB, Alexander Williams J (1978) Lateral subcutaneous sphincterotomy-local or general anaesthesia. Proc R Soc Med 71:29–30

    CAS  Google Scholar 

  17. Gemsenjaeger E (1972) Die Sklerose des Sphincter ani inter-nus. Schweiz Med Wochenschr 102:336–339

    Google Scholar 

  18. Goldberg S, Gordon P, Nivatvongs S (1980) Essentials of anorectal surgery. Lippincott, Philadelphia

    Google Scholar 

  19. Goligher J-C (1965) An evaluation of internal sphincterotomy and simple sphincter-stretching in the treatment of fissure-in-ano. Surg Clin North Am 45:1299–1304

    CAS  PubMed  Google Scholar 

  20. Goligher J-C (1980) Surgery of the anus, rectum and colon, 4th edn. Bailliere Tindall, London

    Google Scholar 

  21. Goodsall DH (1892) Fissure, non-syphilitic and syphilitic of the rectum and anus. St Bartholome’s Hosp Reports 28:205–210

    Google Scholar 

  22. Gorfine SR (1995) Treatment of benign anal disease with topical nitroglycerine. Dis Colon Rectum 38:452–456

    Google Scholar 

  23. Gough MJ, Lewis A (1983) The conservative treatment of fissure-in-ano. Br J Surg 70:175–176

    Article  CAS  PubMed  Google Scholar 

  24. Graham-Stewart CW (1962) The etiology and treatment of fissure-in-ano. Int Abstr Surg 115:511

    Google Scholar 

  25. Hancock BD (1977) The internal sphincter and anal fissure. Br J Surg 64:92–95

    Article  CAS  PubMed  Google Scholar 

  26. Hardy KJ, Cuthbertson AM (1969) Lateral sphincterotomy-an appraisal with special reference to sequelae. Aust NZ J Surg 39:91–92

    Article  CAS  Google Scholar 

  27. Hawley PR (1969) The treatment of chronic fissure-inano. Br J Surg 56:916–918

    Article  Google Scholar 

  28. Herzog U, Gemsenjaeger E (1980) Fissura ani. Schweiz Rundsch Med 47:1734–1743

    Google Scholar 

  29. Hoffmann DC, Goligher JC (1970) Lateral subcutaneous internal sphincterotomy in treatment of anal fistulae. Br Med J 3:671–675

    Article  Google Scholar 

  30. Hsu TC, MacKeigan JM (1984) Surgical treatment of chronic anal fissure. A retrospective study of 1753 cases. Dis Colon Rectum 27:475–478

    Article  CAS  PubMed  Google Scholar 

  31. Hughes ESR (1953) Anal fissure. Br Med J 2:803–805

    Article  CAS  Google Scholar 

  32. Jensen SL, Fund F, Nielsen OV et al (1984) Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in outpatients: a prospective randomised study. Br Med J 289:528–530

    Article  CAS  Google Scholar 

  33. Jost W H, Schimrigk K (1994) Therapy of anal fissure using botulin toxin. Dis Colon Rectum 37:1321–1324

    Article  CAS  PubMed  Google Scholar 

  34. Keighley MRB, Greca F, Nevah E, Hares M, Alexander-Williams J (1981) Treatment of anal fissure by lateral subcutaneous sphincterotomy should be under general anesthesia. Br J Surg 68:400–401

    Article  CAS  PubMed  Google Scholar 

  35. Keighley MRB, Williams NS (1993) Fissure in ano. In: Keighley MRB, Williams NS (ed) Surgery of the anus, rectum and colon. Saunders, London

    Google Scholar 

  36. Khubchandani IT, Reed JF (1989) Sequelae of internal sphincterotomy for chronic fissure-in-ano. Brit J Surg 76:431–434

    Article  CAS  PubMed  Google Scholar 

  37. Kuypers HC (1983) Is there really sphincter spasm in anal fissure. Dis Colon Rectum 26:493–494

    Article  CAS  PubMed  Google Scholar 

  38. Law PJ, Bartram CI (1989) Anal endosonography technique and normal anatomy. Gastrointest Radiol 14:349–353

    Article  CAS  PubMed  Google Scholar 

  39. Leong AFPK, Seow-Choen F (1995) Lateral sphincterotomy compared with anal advancement flap for chronic fissure. Dis Colon Rectum 38:69–71

    Article  CAS  PubMed  Google Scholar 

  40. Lewis TH, Corman ML, Prager ED et al (1988) Long term results of open and closed sphincterotomy for anal fissure. Dis Colon Rectum 31:368–371

    Article  CAS  PubMed  Google Scholar 

  41. Lock MR, Thomson JPS (1977) Fissure-in-ano: the initial management and prognosis. Br J Surg 64:355–358

    Article  CAS  PubMed  Google Scholar 

  42. Lord PH (1972) A new approach to haemorrhoids. Progress in Surgery 10:109–124

    CAS  PubMed  Google Scholar 

  43. MacDonald A, Smith A, McNeil AD et al (1992) Manual dilatation of the anus. Br J Surg 79:1381–1382

    Article  CAS  PubMed  Google Scholar 

  44. MacDonald P, Driscoll AM, Nicholls RJ (1983) The anal dilator in the conservative management of acute anal fissures. Br J Surg 70:25–26

    Article  Google Scholar 

  45. Magee HR, Thompson HR (1966) Internal anal sphincterotomy as an outpatient operation. Gut 7:190–193

    Article  CAS  PubMed  Google Scholar 

  46. Marby M, Alexander-Williams J, Buchmann P, Arabi Y, Kappas A, Menervini S, Gatehouse D, Keighley MRB (1979) A randomized controlled trial to compare anal dilatation with lateral subcutaneous sphincterotomy for anal fissure. Dis Colon Rectum 22:308–311

    Article  CAS  PubMed  Google Scholar 

  47. Marti M-C (1976) Les fissures anales. Praxis 65:1398–1403

    CAS  PubMed  Google Scholar 

  48. Marti M-C (1979) Les fissures anales. Med Hyg 37:285–288

    Google Scholar 

  49. Mazier WP (1972) An evaluation of the surgical treatment of anal fissures. Dis Colon Rectum 15:222–227

    Article  CAS  PubMed  Google Scholar 

  50. Melange M, Colin JF, Van Wymersch T et al. (1992) Anal fissure: correlation between symptoms and manometry before and after surgery. Int J Colorectal Dis 7:108–111

    Article  CAS  PubMed  Google Scholar 

  51. Miles WE (1944) Rectal surgery — a practical guide to the modern surgical treatment of rectal diseases. Cassell, London

    Google Scholar 

  52. Millar DM (1971) Subcutaneous lateral internal anal sphincterotomy for anal fissure. Br J Surg 58:737–739

    Article  CAS  PubMed  Google Scholar 

  53. Nielsen MB, Rasmussen OO, Pedersen et al (1993) Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano. An endosonographic study. Dis Colon Rectum 36:677–680

    Article  CAS  PubMed  Google Scholar 

  54. Northmann BJ, Schuster MM (1974) Internal anal sphincter derangement with anal fissures. Gastroenterology 67:216–220

    Google Scholar 

  55. Notaras MJ (1971) The treatment of anal fissure by lateral subcutaneous internal sphincterotomy — a technique and results. Br J Surg 58:96–100

    Article  CAS  PubMed  Google Scholar 

  56. Nyam DCNK, Wilson RG, Stewart KJ et al (1995) Island advancement flaps in the management of anal fissures. Br J Surg 82:326–328

    Article  CAS  PubMed  Google Scholar 

  57. Parks AG (1967) The management of fissure-in-ano. Br J Hosp Med 1:737–738

    Google Scholar 

  58. Pernikoff BJ, Eisenstat TE, Rubin RJ (1994) Reappraisal of partial lateral internal sphincterotomy. Dis Colon Rectum 37:1291–1295

    Article  CAS  PubMed  Google Scholar 

  59. Ray JE, Penfold JCB, Gathright JB, Roberson SH (1974) Lateral subcutaneous internal anal sphincterotomy for anal fissure. Dis Colon Rectum 17:139–144

    Article  CAS  PubMed  Google Scholar 

  60. Recamier JCA (1838) Extension, massage et percussion ca-dencee dans le traitement des contractures musculaires. Rev Med Fr Etranger 1:74–89

    Google Scholar 

  61. Rudd WWH (1975) Lateral subcutaneous internal sphincterotomy for chronic anal fissure: an outpatient procedure. Dis Colon Rectum 18:319–323

    Article  CAS  PubMed  Google Scholar 

  62. Samson RB, Williams RC, Stewart RC (1970) Sliding skin grafts in the treatment of anal fissures. Dis Colon Rectum 13:372–375

    Article  CAS  PubMed  Google Scholar 

  63. Schouten WR, Briel JW, Auwerda JJA (1994) Relationship between anal pressure and anodermal blood flow. Dis Colon Rectum 37:664–669

    Article  CAS  PubMed  Google Scholar 

  64. Soullard J (1975) Proctologie. Masson, Paris

    Google Scholar 

  65. Speakman CTM, Burnett SJD, Kamm MA, Bartram CI (1991) Sphincter injury following anal dilatation demonstrated by anal endosonography. Br J Surg 78:1429–1430

    Article  CAS  PubMed  Google Scholar 

  66. Sultan AH, Kamm MA, Nicholls RJ et al (1994) Prospective study of the extend of internal anal sphincter division during lateral sphincterotomy. Dis Colon Rectum 37:1031–1033

    Article  CAS  PubMed  Google Scholar 

  67. Watts J MCK, Bennett RC, Goligher JC (1964) Stretching of anal sphincters in the treatment of fissure-in-ano. Br Med J 2:342–343

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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© 1998 Springer-Verlag Berlin Heidelberg

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Marti, MC. (1998). Anal Fissure. In: Marti, MC., Givel, JC. (eds) Surgical Management of Anorectal and Colonic Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10169-8_15

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  • DOI: https://doi.org/10.1007/978-3-662-10169-8_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-10171-1

  • Online ISBN: 978-3-662-10169-8

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