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Background <p>Acute anal fissure is a common cause of severe pain in the anorectal region. The standard treatment is the topical application of a calcium channel blocker or glyceryl trinitrate. Despite acute anal fissure being a common proctologic condition, data on the healing rates and long-term outcomes remain scarce. This study aimed to evaluate data from our centre, with a special focus on long-term follow-up and recurrent disease.</p> Methods <p>All consecutive patients who presented with acute anal fissure between January 2016 and December 2016 were retrospectively identified. Patients were included if their clinical symptoms lasted for less than 6&#xa0;weeks, secondary changes to fissure morphology were absent, and data from follow-up examinations were available. Clinical features, symptoms, therapy and long-term outcomes were evaluated.</p> Results <p>A total of 623 patients with a median age of 45&#xa0;years were included; 342/623 patients were female (54.9%). The median follow-up period was 41&#xa0;months (range 6&#xa0;weeks–89&#xa0;months), and 39.5% of the patients had a follow-up duration exceeding 5&#xa0;years. Most fissures occurred in the 6&#xa0;o’clock lithotomy position (63.7%), in the 12&#xa0;o’clock position (21.0%), or in both (4.5%). In 67/623 patients, the fissure was in an atypical region (10.8%). In 439/623 patients, the fissure healed completely (70.5%). A total of 8.7% of the patients underwent fissurectomy, and 180/623 patients experienced recurrence (28.9%).</p> Conclusions <p>The management of acute anal fissure can be challenging because recurrence is common. Conservative management is successful in the majority of cases. Surgery is necessary only for a minority of patients.</p>

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Therapy and long-term outcomes of acute anal fissure: a high-volume referral centre experience with 623 patients

  • 期刊论文

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  • 发表日期：

    2026年1月6日

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  • S. Fritz,
  • J. Kirsch,
  • N. Schneider,
  • J. Kirsch,
  • C. Reissfelder,
  • A. Herold,
  • D. Bussen

摘要

Background

Acute anal fissure is a common cause of severe pain in the anorectal region. The standard treatment is the topical application of a calcium channel blocker or glyceryl trinitrate. Despite acute anal fissure being a common proctologic condition, data on the healing rates and long-term outcomes remain scarce. This study aimed to evaluate data from our centre, with a special focus on long-term follow-up and recurrent disease.

Methods

All consecutive patients who presented with acute anal fissure between January 2016 and December 2016 were retrospectively identified. Patients were included if their clinical symptoms lasted for less than 6 weeks, secondary changes to fissure morphology were absent, and data from follow-up examinations were available. Clinical features, symptoms, therapy and long-term outcomes were evaluated.

Results

A total of 623 patients with a median age of 45 years were included; 342/623 patients were female (54.9%). The median follow-up period was 41 months (range 6 weeks–89 months), and 39.5% of the patients had a follow-up duration exceeding 5 years. Most fissures occurred in the 6 o’clock lithotomy position (63.7%), in the 12 o’clock position (21.0%), or in both (4.5%). In 67/623 patients, the fissure was in an atypical region (10.8%). In 439/623 patients, the fissure healed completely (70.5%). A total of 8.7% of the patients underwent fissurectomy, and 180/623 patients experienced recurrence (28.9%).

Conclusions

The management of acute anal fissure can be challenging because recurrence is common. Conservative management is successful in the majority of cases. Surgery is necessary only for a minority of patients.