Chronic anal fissures (CAFs) are a prevalent anorectal disorder recognized for causing significant morbidity and reducing the quality of life of those affected. Initially described by Lockhart Mummery, anal fissures are defined as linear or oval-shaped tears in the anoderm. The treatment landscape for CAF has evolved over the years, with options categorized into surgical and non-surgical methods. While lateral sphincterotomy remains the surgical gold standard, various techniques have been developed to minimize complications such as fecal incontinence. Concurrently, the past two decades have witnessed an increasing preference for less invasive, conservative treatment options, including glyceryl trinitrate ointment, local anesthetics such as lidocaine, steroids, calcium channel-blocking drugs, diltiazem ointments, and botulinum toxin injections. Despite the array of available therapies, there remains ongoing debate in the literature regarding their efficacy and safety profiles.

This Research Topic aims to systematically compare different management strategies for chronic anal fissures to determine their efficacy, safety, and impact on patient quality of life. By critically evaluating both surgical and non-surgical interventions, this research looks to establish a clearer understanding of the most effective treatments, potentially leading to improved outcomes for patients with CAF. Central to this investigation are specific questions regarding which methods offer the best balance of efficacy and safety and under what conditions certain strategies outperform others.

To gather further insights into the comparison of these management strategies, we welcome articles addressing, but not limited to, the following themes:

o Comparative analysis of surgical and non-surgical treatments for CAF;
o Long-term outcomes and quality of life post-treatment;
o Advances in minimally invasive procedures for anal fissures;
o Efficacy and safety profiles of novel non-surgical therapies;
o Patient-centered approaches and decision-making factors in CAF treatment.

We accept submissions in the form of original research articles, reviews, and case studies.

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Management Strategies for Chronic Anal Fissures: Efficacy and Safety