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Resumen Introduccion El tratamiento de la fisura anal cronica (FAC) difiere en funcion del profesional. Para plantear un consenso, seria conveniente conocer el estado actual a nivel nacional. El objetivo del presente estudio es conocer la situacion actual del manejo de la FAC en los hospitales espanoles. Metodos Estudio descriptivo, con datos de encuestas a cirujanos de la Asociacion Espanola de Coloproctologia en las que se han recogido datos de la comunidad autonoma, tipo de hospital y categoria profesional, opinion sobre el manejo de la FAC en general y relativa a 3 casos clinicos especificos. Resultados Se ha recibido respuesta de 152 cirujanos. Las medidas farmacologicas constituyen el primer escalon terapeutico (93,38%). En paciente con hipertonia y sin factores de riesgo de incontinencia fecal (IF), el 55,9% emplea medidas higienico-dieteticas asociadas a pomada de nitroglicerina (MHG + NTG). El segundo escalon lo constituiria la esfinterotomia lateral interna (ELI) (43,4%). En paciente con factores de riesgo de IF, se utiliza MHG + NTG (75,7%) y en caso de fracaso, ELI previa ecografia y/o manometria. En paciente joven con hipertonia inexplorable y proctalgia incapacitante sin factores de riesgo de IF, se trataria con MHG + NTG (55,9%) y si fracasa, ELI (46,1%). Conclusiones El manejo de la FAC en Espana presenta similitudes con las recomendaciones que realizan las guias internacionales. Sin embargo, se observan algunas diferencias incluso desde las primeras opciones de tratamiento.

Introduction The treatment of chronic anal fissure (FAC) differs depending on the professional. To come to a consensus, the current situation in Spain should be studied. The aim of this study is to evaluate the current situation of the management of FAC in Spanish hospitals. Methods Descriptive study, with data from a survey of surgeons of the Spanish Association of Coloproctology. Data was collected according to the doctor's autonomous community, type of hospital and professional category; FAC management data and 3 clinical cases. Results Response was obtained from 152 surgeons. Pharmacological measures stand out as the first therapeutic step (93.38%). In patients with hypertonia and with no risk factors for fecal incontinence (FI), 55.9% use hygienic-dietary measures associated with nitroglycerin ointment (MHG+NTG). The second step is internal lateral sphincterotomy (ELI) (43.4%). MHG+NTG (75.7%) is used in patients with FI risk factors and in case of failure, ELI is used with a prior ultrasound and/or manometry. In young patients with unexplained hypertonia and incapacitating proctalgia with no risk factors for FI, MHG+NTG (55.9%) is used and, if it is not successful, they are treated with ELI (46.1%). Conclusions The management of FAC in Spain shows similarities with the international guideline suggestions. Nevertheless, some differences can be seen from the first stages of treatment.