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Background <p>Chronic anal fissures refractory to conservative treatment may require surgery.</p> Objective <p>Recommendations for the surgical treatment of primary chronic anal fissures.</p> Materials and methods <p>Literature review, analysis of guidelines and expert recommendations.</p> Results <p>The chronic anal fissure is distinguished from the acute form by the duration of symptoms (more than 6–8&#xa0;weeks) as well as secondary changes such as the sentinel pile, the hypertrophic anal papilla, and the scarred margin. The preferred treatment is initially conservative. However, if this is unsuccessful, surgical treatment may be considered. Surgical options include fissurectomy, possibly combined with an anal advancement flap in various forms, as well as lateral sphincterotomy in different variations. In Germany, fissurectomy is the preferred procedure. These interventions are typically performed on an outpatient basis, accompanied by appropriate perioperative management.</p> Conclusion <p>Surgical treatment of chronic anal fissures is considered when conservative therapy fails. Postoperative complications, besides recurrence, include wound healing disturbances and incontinence.</p>

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Operative Therapie der Analfissur

  • 期刊论文

  • 发表日期：

    2025年5月22日

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  • Ricarda Diller

摘要

Background

Chronic anal fissures refractory to conservative treatment may require surgery.

Objective

Recommendations for the surgical treatment of primary chronic anal fissures.

Materials and methods

Literature review, analysis of guidelines and expert recommendations.

Results

The chronic anal fissure is distinguished from the acute form by the duration of symptoms (more than 6–8 weeks) as well as secondary changes such as the sentinel pile, the hypertrophic anal papilla, and the scarred margin. The preferred treatment is initially conservative. However, if this is unsuccessful, surgical treatment may be considered. Surgical options include fissurectomy, possibly combined with an anal advancement flap in various forms, as well as lateral sphincterotomy in different variations. In Germany, fissurectomy is the preferred procedure. These interventions are typically performed on an outpatient basis, accompanied by appropriate perioperative management.

Conclusion

Surgical treatment of chronic anal fissures is considered when conservative therapy fails. Postoperative complications, besides recurrence, include wound healing disturbances and incontinence.