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CC BY 4.0 · Journal of Coloproctology 2025; 45(03): s00451810613
DOI: 10.1055/s-0045-1810613
Original Article

The Practices and Preferences of Turkish Surgeons in the Treatment of Anal Fissure

Authors

  • Ümit Özdemir 

    1   Department of General Surgery, Section of Gastroenterological Surgery, Ankara Etlik City Hospital, Ankara, Türkiye

  • Necip Tolga Baran 

    1   Department of General Surgery, Section of Gastroenterological Surgery, Ankara Etlik City Hospital, Ankara, Türkiye

  • Ahmet Seki 

    1   Department of General Surgery, Section of Gastroenterological Surgery, Ankara Etlik City Hospital, Ankara, Türkiye

Funding The author(s) received no financial support for the research.
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Abstract

Objective

Despite different medical and surgical options for the treatment of anal fissure no international consensus has been reached. The aim of this study was to determine current practices and preferences of Turkish surgeons when treating anal fissure.

Methods

Two groups were formed according to numbers of anal fissure patients treated per year (0-50 or >50 patients) and were then compared in respect of responses to questions about diagnosis, treatment and clinical approaches to anal fissure.

Results

A total of 300 Turkish surgeons completed the questionnaire: 50.7% in Group 1 (0-50 patients per year) and 49.3% in Group 2 (>50 patients per year). The leading diagnostic method was reported to be physical examination (84.0%). The first approach in treatment was support treatment + topical medical treatment together (82.0%), and when this does not provide recovery, the next option is lateral internal sphincterotomy (LIS) (54.5%). Botulinium toxin injection (BTI) was preferred more by the Group 2 respondents (13.8% vs.23.0%). The use of phlebotonic drugs was lower in Group 2 (45.4% vs.33.1%, p = 0.029). Fetal incontinence is considered in the decision for LIS (82.8%). Limited application of BTI was reported (38.7%) and 17.0% stated that in healthcare facilities in Türkiye there was no institutional treatment protocol for anal fissure.

Conclusion

Main lines of anal fissure treatment in daily practice in Türkiye are in parallel with current international practice. For the updating and standardization of anal fissure treatment, national meetings and studies must be increased and a national anal fissure treatment algorithm should be prepared.

Keywords

anal fissure - lateral internal sphincterotomy - anal fissure treatment - Botulinium toxin injection - national survey

Ethical Statement

All authors declare that the study was conducted in accordance with the Declaration of Helsinki and followed the ethical standards of Türkiye. Approval was granted by the Ethics Committee of Ankara Etlik City Hospital (Date:20.03.2024, No: AEŞH-BADEK-2024-194).


Authors' Contributions

ÜO, NTB, AS: material preparation, data collection, data analysis. ÜO: writing – original draft. All authors contributed to the conception and design of the study, critical review of the manuscript, and final approval.




Publication History

Received: 11 March 2025

Accepted: 16 July 2025

Article published online:
10 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Ümit Özdemir, Necip Tolga Baran, Ahmet Seki. The Practices and Preferences of Turkish Surgeons in the Treatment of Anal Fissure. Journal of Coloproctology 2025; 45: s00451810613.
DOI: 10.1055/s-0045-1810613