Abstract
Most acute anal fissures respond to conservative therapy. Historically, surgery has been the mainstay of treatment for chronic anal fissures with relatively simple procedures resulting in excellent cure rates. However, surgical treatments may be associated with permanent disruptions in continence, sparking interest in pharmacologic manipulation. Despite the conceptual appeal of these approaches, their ability to reliably effect healing of chronic fissures is highly suspect. As such, a more prompt decision for surgery may be warranted. © 2003 Elsevier Inc. All rights reserved.
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