letter to the editor: surgical treatment of chronic anal fissure

We have read an interesting article in acta medica iranica by mohammad reza motie and parham hashemi, who have reported their experience about chronic anal fissure (caf), comparing medical treatment versus surgical sphincterotomy (1). they retrospectively evaluated 190 patients who were referred for caf between the years 2005-2010 to imam reza hospital, who were divided on the basis of the therapy proposed: medical treatment with topical nitroglycerin (group a), topical diltiazem (group b) and surgical approach with comparing surgical lateral internal sphincterotomy (group c). relieve of pain was achieved in 77%, 83% and 98% in group a, b, and c, respectively. fissure healing was obtained in 74%, 83%, and 94% of group a, b and c patients. surgical treatment was found to be more effective than medical one in their series.