2 Results of a national survey among gastrointestinal surgeons 47 that consists of members that have large experience and affiliation in treating anorectal diseases. Of all respondents, 33% came from this group. This may have caused selection bias. Third, we used a non-validated questionnaire and respondents were self-reported. Self-reports may have resulted in an overestimation of history-taken practices and to our knowledge, validated questionnaires are not available in this field. Conclusion Guideline recommendations in treating CAF are largely followed and consistent among most gastrointestinal surgeons in the Netherlands. Initial treatment consists of conservative measures followed by surgical procedures. Surgeons do not consistently assess pelvic floor complaints, nor do they routinely examen the pelvic floor muscles. Awareness of pelvic floor dysfunctions in patients with CAF is important to refer patients for pelvic floor physical therapy. What does this paper add to the literature? Gastrointestinal surgeons in the Netherlands have not yet been surveyed regarding their current management concerning chronic anal fissure. The paper discusses similarities and discordances between surgeons and compare these to current Dutch and international guidelines. Furthermore, it emphasizes the focus on the pelvic floor in current management of CAF. Table 1. Results Respondents’ characteristics N (%) What is your medical specialty? Gastrointestinal surgeon General surgeon Fellow Resident in training Physician assistant/nurse practitioner 86 (81) 7 (7) 2 (2) 8 (7) 3 (3) What type of hospital are you working? Academic Non-academic (peripheral) (Private) clinic 4 (4) 94 (89) 8 (7) How many years of work experience do you have as a medical specialist in the treatment of CAF? 1-5 years 5-10 years 10-20 years >20 years 19 (18) 24 (23) 35 (33) 28 (26)
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