Open lateral sphincterotomy is still the best treatment for chronic anal fissure

Chronic anal fissure is the main cause of anal pain and is very common. Man y treatment modalities have been tried-none is ideal. Recently, topical nit ric oxide releasing agents and botulin toxin injections have been used, try ing to replace surgery. No long-term experience is available. Personal expe rience with 2,108 open, ambulatory, lateral sphincterotomy with follow-up o f 4-20 years is presented. (C) 2000 by Excerpta Medica, Inc.