What surgical procedure is reasonable for treating an anal fissure in a young man?

The surgical procedure that is reasonable for treating an anal fissure in a young man is the surgical division of the internal anal sphincter. This procedure, known as lateral internal sphincterotomy, is particularly effective in managing chronic anal fissures that do not respond to conservative treatments.

In cases of anal fissures, especially when they become chronic, the underlying issue often involves increased anal sphincter tension, which can lead to persistent pain and difficulty with bowel movements. By surgically dividing a portion of the internal anal sphincter, the procedure alleviates this tension, thereby promoting healing of the fissure and providing significant pain relief for the patient.

This approach is favored because it addresses the fundamental problem of high sphincter pressure. It also has a relatively low complication rate and can lead to improved outcomes in terms of both symptom relief and quality of life for patients suffering from this condition.

Other procedures listed might not be as effective for specifically treating anal fissures. For example, hemorrhoidectomy primarily addresses hemorrhoids and could exacerbate fissure symptoms. Fistulectomy is used for anal fistulas, and anal dilation may provide temporary relief but does not offer a definitive solution to chronic anal fissures. Therefore, surgical division of