{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:57:05Z","timestamp":1781690225509,"version":"3.54.5"},"reference-count":25,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Anal fissure is a common benign condition, yet its management varies widely. The International Society of University Colon and Rectal Surgeons (ISUCRS) conducted a global snapshot audit to describe contemporary real-world management patterns. Methods: During a 2-week period (June\u2013July 2022), 56 colorectal surgeons from 21 countries prospectively recorded data for consecutive patients presenting with anal fissure. Exclusion criteria included inflammatory bowel disease, pregnancy or lactation, psychiatric disorders, immunosuppression, and anorectal sepsis. Acute fissure was defined as symptoms &lt;6 weeks without sentinel pile; chronic fissure as &gt;6 weeks or fibrotic edges\/sentinel pile. The \u201cCure\u201d was defined as complete symptom resolution or healed fissure on clinical or tele-follow-up. Results: A total of 302 patients were analyzed (mean age 41 \u00b1 13 years; 52% women). Acute fissure was present in 42%, chronic in 58%. Conservative treatment (dietary advice, stool-softeners, topical agents, botulin toxin, pelvic-floor training) was initiated in 236 (78%) patients, while 66 (22%) underwent surgery, most commonly lateral internal sphincterotomy (LIS). At 8-week follow-up, 73% of patients treated conservatively and 88% of those treated surgically achieved clinical resolution of symptoms or healed fissure. Conclusions: Global management of anal fissure remains heterogeneous. Most surgeons favor conservative measures such as first-line therapy, reserving LIS for chronic or refractory fissures. Standardized definitions and outcome reporting are needed to improve comparability and guide future international guidelines.<\/jats:p>","DOI":"10.3390\/jcm15124677","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:27:21Z","timestamp":1781666841000},"page":"4677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Management of Anal Fissure: Results from the ISUCRS 2022 Snapshot Audit"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3692-8962","authenticated-orcid":false,"given":"Audrius","family":"Dulskas","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"},{"name":"National Cancer Institute, LT-08406 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Nunoo-Mensah","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, King\u2019s College Hospital Foundation NHS Trust, London SE5 9RS, UK"},{"name":"Cleveland Clinic, London SW1X 7HY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1719-2582","authenticated-orcid":false,"given":"Richard","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Huneidy","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dursun","family":"Bugra","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Vehbi Ko\u00e7 Foundation (VKV), American Hospital, 34365 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2252-9509","authenticated-orcid":false,"given":"Varut","family":"Lohsiriwat","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1160-8233","authenticated-orcid":false,"given":"Tomas","family":"Aukstikalnis","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narimantas E.","family":"Samalavicius","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"},{"name":"Department of Surgery, Vilnius Republic University Hospital, LT-04130 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref_1","unstructured":"Jahnny, B., and Ashurst, J.V. 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