Surgical management and therapeutic prospectus of anal fistula: a review

A fissure in ano is a tear in the anoderm distal to the dentate line. The pathophysiology of anal fissure is thought to be related to trauma to the anoderm from any cause. A tear in the anoderm causes acute pain, which results in spasm of the internal anal sphincter and decreased blood supply to the anoderm. This cycle of pain, spasm and ischemia contributes to development of a poorly healing wound that becomes a chronic fissure. In this review article our aim to discuss the surgical management and therapeutic prospectus of anal fistula.