ReviewTechniques in coloproctology2011
The management of patients with primary chronic anal fissure: a position paper.
Review in Techniques in coloproctology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04320498 (Effects of Platelet-rich Plasma in the Treatment of Chronic Anal Fissure), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Platelet-rich Plasma in the Treatment of Chronic Anal Fissure
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- Botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials.Techniques in coloproctology · 2014Pooled it
- Topical Minoxidil Versus Topical Diltiazem for Chemical Sphincterotomy of Chronic Anal Fissure: A Prospective, Randomized, Double-Blind, Clinical Trial.World journal of surgery · 2018Trial
- Myoxinol ointment for the treatment of acute fissure.Updates in surgery · 2017Trial
- Maintenance therapy with partially hydrolyzed guar gum in the conservative treatment of chronic anal fissure: results of a prospective, randomized study.BioMed research international · 2014Trial
- Conservative versus surgical treatment for chronic anal idiopathic fissure: a prospective randomized trial.Updates in surgery · 2013Trial
- Outcome of lateral internal sphincterotomy for anal fissure in a retrospective cohort of patients.Updates in surgery · 2026Article
- Global Management of Anal Fissure: Results from the ISUCRS 2022 Snapshot Audit.Journal of clinical medicine · 2026Article
- Article
- Therapy and long-term outcomes of acute anal fissure: a high-volume referral centre experience with 623 patients.Techniques in coloproctology · 2026Article
- [Chronic anal fissure-Cremes or surgery?]Chirurgie (Heidelberg, Germany) · 2025Review
- Efficacy of botulinum toxin in the treatment of chronic anal fissure: a comprehensive systematic review.Annals of medicine and surgery (2012) · 2025Article
- Assessing the Quality and Readability of Online Patient Information for Common Proctological Conditions.Cureus · 2025Article
- Description and management of patients with anal fissure: insights on Italian primary care setting coming from real-world data.Updates in surgery · 2024Article
- Surgeons' practice and preferences for the anal fissure treatment: results from an international survey.Updates in surgery · 2023Article
- Safety and efficacy of Levorag emulgel in the treatment of anal fissures using a validated scoring system.Frontiers in surgery · 2023Article
- Colorectal Surgery Practice, Training, and Research in Low-Resource Settings.Clinics in colon and rectal surgery · 2022Review
- Comparison of botulinum toxin (BoNT) injection and lateral internal sphincterotomy (redo-LIS) for recurrent anal fissure treatment.Frontiers in surgery · 2022Article
- Anocutaneous advancement flap provides a quicker cure than fissurectomy in surgical treatment for chronic anal fissure-a retrospective, observational study.Langenbeck's archives of surgery · 2021Observational
- Fissurectomy and anoplasty in posterior normotensive chronic anal fissure.Acta bio-medica : Atenei Parmensis · 2021Article
- Safety and effectiveness of saving sphincter procedure in the treatment of chronic anal fissure in female patients.BMC surgery · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anal fissure is one of the most common and painful proctologic diseases. Its treatment has long been discussed and several different therapeutic options have been proposed. In the last decades, the understanding of its pathophysiology has led to a progressive reduction of invasive and potentially invalidating treatments in favor of conservative treatment based on anal sphincter muscle relaxation. Despite some systematic reviews and an American position statement, there is ongoing debate about the best treatment for anal fissure. This review is aimed at identifying the best treatment option drawing on evidence-based medicine and on the expert advice of 6 colorectal surgeons with extensive experience in this field in order to produce an Italian position statement for anal fissures. While there is little chance of a cure with conservative behavioral therapy, medical treatment with calcium channel blockers, diltiazem and nifepidine or glyceryl trinitrate, had a considerable success rate ranging from 50 to 90%. Use of 0.4% glyceryl trinitrate in standardized fashion seems to have the best results despite a higher percentage of headache, while the use of botulinum toxin had inconsistent results. Nonresponding patients should undergo lateral internal sphincterotomy. The risk of incontinence after this procedure seems to have been overemphasized in the past. Only a carefully selected group of patients, without anal hypertonia, could benefit from anoplasty.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.