Open lateral sphincterotomy is still the best treatment for chronic anal fissure.

@article{Argov2000OpenLS,
  title={Open lateral sphincterotomy is still the best treatment for chronic anal fissure.},
  author={Samuel Argov and Olga Levandovsky},
  journal={American journal of surgery},
  year={2000},
  volume={179 3},
  pages={201-2}
}
Chronic anal fissure is the main cause of anal pain and is very common. Many treatment modalities have been tried-none is ideal. Recently, topical nitric oxide releasing agents and botulin toxin injections have been used, trying to replace surgery. No long-term experience is available. Personal experience with 2,108 open, ambulatory, lateral sphincterotomy with follow-up of 4-20 years is presented. 

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