Old anal fissures accompanied by anterior hemorrhoids indicate a long localized course and can be treated surgically if the localized condition is more severe. Old anal fissure indicates that the disease duration of anal fissure is relatively long, usually more than three months. Long-term recurrent anal fissure patients, there may be localized fissure ulcerative changes, and the fissure of the old anal fissure is not easy to completely heal, showing the characteristics of recurrent episodes. During the episodes, the patient will also have different degrees of localized anal blood and pain, as well as moist and itchy perianal area due to long-term secretion stimulation of the fissure. Anal fissure long-term stimulation of the anus, the local will form a skin drop of external hemorrhoids or sentinel hemorrhoids, sentinel hemorrhoids have formed a local organic lesions, can not be retracted or eliminated. When anal fissure patients have the above recurrent characteristics or localized sentinel hemorrhoids, causing localized foreign body sensation in the anus and frictional pain, surgical excision can be carried out, for patients with old anal fissure, surgery is a more ideal treatment. Surgery is mainly used for anal fissure internal sphincter lateral resection and external hemorrhoidectomy.