{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:45:59Z","timestamp":1771231559876,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"6444","license":[{"start":{"date-parts":[[1984,9,1]],"date-time":"1984-09-01T00:00:00Z","timestamp":462844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,9,1]]},"abstract":"<jats:p>Fifty eight patients with idiopathic chronic anal fissure were included in a randomised prospective trial of lateral subcutaneous sphincterotomy versus simple anal dilatation carried out as outpatient procedures. Operations were performed under local anaesthesia and the patients reviewed 10-30 months later (median follow up time 18 months). Altogether 30 patients were treated by lateral subcutaneous sphincterotomy and 28 by anal dilatation. No serious complications were observed in either group. One recurrence was observed in the group treated by sphincterotomy, whereas eight occurred in the other group (p less than 0.05). Functional results with respect to impaired control of flatus and soiling of underwear were significantly better after sphincterotomy (p less than 0.002). It is concluded that lateral subcutaneous sphincterotomy is the treatment of choice for idiopathic chronic anal fissure resistant to conservative measures.<\/jats:p>","DOI":"10.1136\/bmj.289.6444.528","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"528-530","source":"Crossref","is-referenced-by-count":95,"title":["Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in outpatients: a prospective randomised study."],"prefix":"10.1136","volume":"289","author":[{"given":"S L","family":"Jensen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Lund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O V","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Tange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1984,9,1]]},"reference":[{"key":"ref_1","article-title":"Surgery of anus, rectum and colon","author":"Goligher, J.C.","year":"1980","unstructured":"Goligher JC. Surgery of anus, rectum and colon. 4th ed. London: Bailliere Tindall, 1980.","edition":"4th ed"},{"issue":"1","key":"ref_2","first-page":"342","article-title":"Stretching of the anal sphincters in the treatment of fissure-in-ano","volume":"289","author":"MEDICAL, B.R.I.T.I.S.H.","year":"1984","unstructured":"BRITISH MEDICAL JOURNAL VOLUME 289 1 SEPTEMBER 1984 2 Watts JM, Bennett RC, Goligher JC. Stretching of the anal sphincters in the treatment of fissure-in-ano. Br Med 7 1965;ii:342-4.","journal-title":"JOURNAL VOLUME"},{"issue":"1","key":"ref_3","first-page":"35","article-title":"Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II: Analysis and examples","volume":"1977","author":"Peto, R.; Pike, M.C.; Armitage, P.","unstructured":"Peto R, Pike MC, Armitage P, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II: Analysis and examples. BrJ Cancer 1977;,1:35-9.","journal-title":"BrJ Cancer"},{"key":"ref_4","first-page":"461","article-title":"Comparison of lateral subcutaneous sphincterotomy with anal dilatation in the treatment of fissure in ano. MedJ3 Aust","volume":"ii:","author":"Collopy, M.B.; Ryan, P.","year":"1979","unstructured":"Collopy MB, Ryan P. Comparison of lateral subcutaneous sphincterotomy with anal dilatation in the treatment of fissure in ano. MedJ3 Aust 1979;ii:461-2."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1136\/bmj.3.5724.673","article-title":"Lateral subcutaneous internal sphincterotomy in treatment of anal fissure","volume":"iii:","author":"Hoffman, D.C.; Goligher, J.C.","year":"1970","unstructured":"Hoffman DC, Goligher JC. Lateral subcutaneous internal sphincterotomy in treatment of anal fissure. Br Med J 1970;iii:673-5.","journal-title":"Br Med J"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1007\/BF02586402","article-title":"Lateral internal sphincterotomy","volume":"21","author":"Bailey, R.V.; Rubin, R.J.; Salvali, E.P.","year":"1978","unstructured":"Bailey RV, Rubin RJ, Salvali EP. Lateral internal sphincterotomy. Dis Colon Rectum 1978;21:584-6.","journal-title":"Dis Colon Rectum"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/bjs.1800580204","volume":"58","author":"technique; results","year":"1971","unstructured":"-technique and results. BraJ Surg 1971;58:96-8.","journal-title":"BraJ Surg"},{"key":"ref_8","author":"Accepted 153June 1984)","unstructured":"(Accepted 153June 1984)"},{"key":"ref_9","first-page":"144","article-title":"What is post-lumbar puncture headache and is it avoidable ?","volume-title":"Dilemmas in the management of the neurological patient","author":"Hilton-Jones, D.","year":"1984","unstructured":"Hilton-Jones D. What is post-lumbar puncture headache and is it avoidable ? In: Warlow C, Garfield T, eds. Dilemmas in the management of the neurological patient. Edinburgh: Churchill Livingstone, 1984;144-57."},{"issue":"14","key":"ref_10","first-page":"806","article-title":"Lumbar puncture headache","volume":"1925","author":"Alpers, B.J.","unstructured":"Alpers BJ. Lumbar puncture headache. Archives of Neurology and Psychiatry 1925;14:806-12.","journal-title":"Archives of Neurology and Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/j.1526-4610.1972.hed1202073.x","article-title":"A randomised double blind clinical trial comparing the 22 versus 26 gauge needle in the production of the post-lumbar puncture syndrome in normal individuals","volume":"12","year":"1972","unstructured":"Tourtellotte WW, Henderson WG, Tucker RP, Gilland 0, Walker JE, Kokman E. A randomised double blind clinical trial comparing the 22 versus 26 gauge needle in the production of the post-lumbar puncture syndrome in normal individuals. Headache 1972;12:73-8.","journal-title":"Headache"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/S0140-6736(81)90586-9","article-title":"Lumbar puncture headache: controlled study on the preventive effect of 24 hours'","volume":"ii:","author":"Carbaat, P.A.T.; van Crevel, H.","year":"1981","unstructured":"Carbaat PAT, van Crevel H. Lumbar puncture headache: controlled study on the preventive effect of 24 hours' bedrest. Lancet 1981;ii:1133-5.","journal-title":"bedrest. Lancet"},{"key":"ref_13","first-page":"343","article-title":"Read D. Subdural haematoma as a complication of spinal anaesthesia","volume":"285","author":"Newrick, P.","year":"1982","unstructured":"Newrick P, Read D. Subdural haematoma as a complication of spinal anaesthesia. Br MedJ3 1982;285:343-4."},{"key":"ref_14","article-title":"Accepted 24","year":"1984","unstructured":"(Accepted 24 May 1984)"},{"key":"ref_15","article-title":"Bed rest for 24 hours is still arbitrarily recommended as a means of preventing headache but does not do so,' for the dural hole will take longer than 24 hours to heal. Clearly, however, an established headache is relieved by increasing the cerebrospinal fluid pressure with bedrest. Early mobilisation is practised exclusively by some doctors in both inpatients and outpatients, though the use of small needles has added to their confidence in doing so. There is a theoretical possibility of subdural haematoma complicating spinal puncture, though Oral contraceptives and stroke: findings in a large prospective study The suggestion that use of oral contraceptives might increase the risk of stroke was first made over 20 years ago, but controlled studies of this problem are few. We have therefore reviewed the data on stroke that have accumulated in the Oxford Family Planning Association contraceptive study","unstructured":"Bed rest for 24 hours is still arbitrarily recommended as a means of preventing headache but does not do so,' for the dural hole will take longer than 24 hours to heal. Clearly, however, an established headache is relieved by increasing the cerebrospinal fluid pressure with bedrest. Early mobilisation is practised exclusively by some doctors in both inpatients and outpatients, though the use of small needles has added to their confidence in doing so. There is a theoretical possibility of subdural haematoma complicating spinal puncture, though Oral contraceptives and stroke: findings in a large prospective study The suggestion that use of oral contraceptives might increase the risk of stroke was first made over 20 years ago, but controlled studies of this problem are few. We have therefore reviewed the data on stroke that have accumulated in the Oxford Family Planning Association contraceptive study."},{"key":"ref_16","article-title":"methods, and results The methods used in the Oxford Family Planning Association study have been described.' The investigation includes over 17 000 women who, when recruited between 1968 and 1974, were all married and aged 25-39. Fifty six per cent were using oral contraceptives, 25%, a diaphragm, and 190, an intrauteride device. During follow up, among other items, data are recorded about changes in contraceptive methods, hospital referrals, and deaths. Discharge summaries are obtained for inpatient spells and as much information as possible is collected about fatal illnesses","author":"Subjects","unstructured":"Subjects, methods, and results The methods used in the Oxford Family Planning Association study have been described.' The investigation includes over 17 000 women who, when recruited between 1968 and 1974, were all married and aged 25-39. Fifty six per cent were using oral contraceptives, 25%, a diaphragm, and 190, an intrauteride device. During follow up, among other items, data are recorded about changes in contraceptive methods, hospital referrals, and deaths. Discharge summaries are obtained for inpatient spells and as much information as possible is collected about fatal illnesses."},{"key":"ref_17","article-title":"At the end of January 1984 data accumulated during 192 000 woman years","unstructured":"At the end of January 1984 data accumulated during 192 000 woman years"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.289.6444.528","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.289.6444.528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T22:22:45Z","timestamp":1765405365000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.289.6444.528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,9,1]]},"references-count":17,"journal-issue":{"issue":"6444","published-online":{"date-parts":[[1984,9,1]]},"published-print":{"date-parts":[[1984,9,1]]}},"alternative-id":["10.1136\/bmj.289.6444.528"],"URL":"https:\/\/doi.org\/10.1136\/bmj.289.6444.528","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1984,9,1]]}}}