title: [Surgical or biologic sphincterotomy in the treatment of chronic anal fissure].
abstract: BACKGROUND
  Chronic anal fissure is a lineal ulcer of the lower part of the anal canal. It is a painful condition characterized by postdefecational pain and bleeding. It is associated with internal anal sphincter spasm. The relief of internal anal sphincter spasm is the key for providing fissure healing. Gold standard in the treatment of chronic anal fissure is partial lateral internal anal sphincterotomy.
  
  
  METHODS
  Sixty patients with chronic anal fissure were randomly assigned into two groups treated either by surgical sphincterotomy or injections of botulinum toxin into internal anal sphincter. Manometric measurements were performed before and three months after treatment. Follow up period was six months. The aim of the study was to compare results between these two groups.
  
  
  RESULTS
  Both methods efficiently reduced resting anal pressure and successfully healed chronic anal fissure.
  
  
  CONCLUSIONS
  Surgical and biologic sphincterotomy are almost equally effective in the treatment of chronic anal fissure. Injecting botulinum toxin into internal anal sphincter is a safe, easy to apply and effective method in the management of anal fissure.
authors: University Department of Surgenr, Merkur University Hospital, Zagreb, Croatia. ssuknaic@inet.hr
authors: Slaven
authors: S
authors: Suknaić
authors: Leonardo
authors: L
authors: Patrlj
authors: Mario
authors: M
authors: Steresinić
authors: Andrija
authors: A
authors: Skopljanac Macina
authors: Lidija
authors: L
authors: Erdelez
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D002908:Chronic Disease; D005260:Female; D005401:Fissure in Ano / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A