Scholz T Hetzer FH Dindo D Demartines N Clavien PA Hahnloser D 2007 BACKGROUND AND AIMS Chronic anal fissures are difficult to treat. The aim of this retrospective study was to determine the outcome of combined fissurectomy and injection of botulinum toxin Type A (BT). MATERIALS AND METHODS Between January 2001 and August 2004, 40 patients (21 women), median age 37 years (range 18 to 57), underwent fissurectomy and BT injection. Fissurectomy was performed followed by injection of 10 U of BT into the internal anal sphincter on both sides of the fissure. All patients were clinically checked 6 weeks after the operation. At 1 year, patients were sent a detailed questionnaire regarding symptoms, recurrence and further treatment for evaluation of long-term results. RESULTS/FINDINGS At 6 weeks, 38 patients (95%) were free of symptoms. No adverse effects were detected. The response rate of questionnaires was 93%; the median follow-up was 1 year (range 0.9 to 1.6). In the long-term, a recurrence was found in four patients. These patients were treated successfully with repeated fissurectomy and BT injections and salvage procedures, respectively. Overall, the success rate of combined fissurectomy and BT injection was 79%. INTERPRETATION/CONCLUSION Combined fissurectomy and Botox injection for chronic anal fissure is an excellent and safe procedure with low morbidity and a high healing rate. application/pdf https://sonar.ch/global/documents/219561 eng info:eu-repo/semantics/altIdentifier/doi/10.1007/s00384-006-0261-z info:eu-repo/semantics/altIdentifier/pmid/17262202 info:eu-repo/semantics/openAccess International journal of colorectal disease. - 2007 Adolescent Adult Botulinum Toxins, Type A Chronic Disease Drug Therapy, Combination Female Fissure in Ano Follow-Up Studies Humans Male Middle Aged Neuromuscular Agents Retrospective Studies Treatment Outcome Wound Healing Long-term follow-up after combined fissurectomy and Botox injection for chronic anal fissures. http://purl.org/coar/resource_type/c_6501