Ragade anale acuta: Terapia medica vs terapia chirurgica

Background. Anal fissure represents a frequent pathology and often is associated with other proctological disorders. Methods. The authors analyze the results of surgical vs conservative treatment in 70 consecutive patients affected by acute anal fissure. The first group (35 patients) underwent anal dilatation with anal dilatator while in the second a closed lateral left sfinterotomy (CLLS) according to Notaras technique was performed, generally in local anesthesia. Results. Usually the complete relief of symptoms was obtained in 68.5% of the first group and in 100% of the second group of patients with a relative morbidity of 5.7% (2/35 perianal hematoma). Conclusions. According to literature data, the authors point out that, in the treatment of acute anal fissure, the CLLS allows better results with a low incidence of long term relapse. The operation is well tolerated with immediate resolution of the pain.