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
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
