Fissurectomy combined with botulinum toxin A injection for medically resistant chronic anal fissures

Abstract

Fissurectomy in combination with Botulinum Toxin A injection in the internal anal sphincter is an effective treatment for medically resistant CAFs.

Fisurectomy and anoplasty with botulinum toxin injection in patients with chronic anal posterior fissure with hypertonia: a long-term evaluation

“…Nevertheless, it has been recently reconsidered as a valid treatment for CAF both in children and adults [12]. This latter surgical procedure has been associated with pharmacological sphincterotomy to improve its results, as well as reduce its complications [15][16][17][18][19][20]. After surgical fissurectomy, with or without association with chemical sphincterotomy [13,15,[21][22][23][24][25][26], we observe a complete second intention wound healing, even after 10 weeks and the rate of failure con reach the 34% [24].…”

Five‐year results of fissurectomy for chronic anal fissure : low recurrence rate and minimal effect on continence

“…In recent years there has been growing interest in fissurectomy as a sphincter-sparing technique, with favourable short-term results. Interpretation of some reports may be difficult because it was often used in combination with other treatments, both medical and surgical [15][16][17][18][19][20][21]. Early results without closure of the wounds combined with NO donor ointment have been favourable [9].…”

Advancement flap in the management of chronic anal fissure: a prospective study

“…They combined local isosorbide dinitrate with fissurectomy in 15 patients and described healing rates of 100 % within a follow-up of 29 months [22]. Few recent studies [4,[23][24][25][26][27][28] To cover the exposed area after fissurectomy, an advancement skin graft has been mostly used. Only recently, a mucosal advancement flap has been used [29,30].…”