Operative procedures for fissure in ano

Abstract

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

Comparing closed versus open lateral internal sphincterotomy for management of chronic anal fissure: systematic review and meta-analysis of randomised control trials

“…The result of this meta-analysis is consistent with a Cochrane analysis of five studies with 336 patients, which found no statistically significant difference between open and closed laternal internal sphincterotomy in terms of postoperative incontinence and healing rate 45 .…”

Comparing closed versus open lateral internal sphincterotomy for management of chronic anal fissure: systematic review and meta-analysis of randomised control trials

“…The result of this meta-analysis is consistent with a Cochrane analysis of five studies with 336 patients, which found no statistically significant difference between open and closed laternal internal sphincterotomy in terms of postoperative incontinence and healing rate 45 .…”

Clinical Outcomes of Medical Management Options for Chronic Anal Fissures in a Long-Term Follow-up: Systematic Review and Meta-Analysis

“…Despite that, calcium channel blockers showed greater efficacy in healing CAF, showing a better outcome when using nifedipine, than when using other treatments (glyceryl trinitrate or stearate ointment, stool softeners, lidocaine ointment 1.5%, and hydrocortisone acetate ointment 1%). Botulinum toxin compared with other topical treatments showed no superiority in the cure of CAF, as demonstrated by other studies [11,27,45]. The results of this study indicate that the use of botulinum toxin as a primary agent in the treatment of anal fissures is not recommended, instead, it could offer real benefits as a second-line treatment.…”

Perspective Chapter: The Management of Chronic Anal Fissures

“…The results of these two techniques have been studied in multiple opportunities, and in a Cochrane review updated in 2011, similar success and recurrence rates were reported. Fecal incontinence rates are also comparable [14].…”

Comparing closed versus open lateral internal sphincterotomy for management of chronic anal fissure: systematic review and meta-analysis of randomised control trials

“…The result of this meta-analysis is consistent with a Cochrane analysis of five studies with 336 patients, which found no statistically significant difference between open and closed laternal internal sphincterotomy in terms of postoperative incontinence and healing rate 45 .…”

Clinical Outcomes of Medical Management Options for Chronic Anal Fissures in a Long-Term Follow-up: Systematic Review and Meta-Analysis

“…Despite that, calcium channel blockers showed greater efficacy in healing CAF, showing a better outcome when using nifedipine, than when using other treatments (glyceryl trinitrate or stearate ointment, stool softeners, lidocaine ointment 1.5%, and hydrocortisone acetate ointment 1%). Botulinum toxin compared with other topical treatments showed no superiority in the cure of CAF, as demonstrated by other studies [11,27,45]. The results of this study indicate that the use of botulinum toxin as a primary agent in the treatment of anal fissures is not recommended, instead, it could offer real benefits as a second-line treatment.…”

Perspective Chapter: The Management of Chronic Anal Fissures

“…The results of these two techniques have been studied in multiple opportunities, and in a Cochrane review updated in 2011, similar success and recurrence rates were reported. Fecal incontinence rates are also comparable [14].…”

Comparing closed versus open lateral internal sphincterotomy for management of chronic anal fissure: systematic review and meta-analysis of randomised control trials

“…The result of this meta-analysis is consistent with a Cochrane analysis of five studies with 336 patients, which found no statistically significant difference between open and closed laternal internal sphincterotomy in terms of postoperative incontinence and healing rate 45 .…”

Clinical Outcomes of Medical Management Options for Chronic Anal Fissures in a Long-Term Follow-up: Systematic Review and Meta-Analysis

“…Despite that, calcium channel blockers showed greater efficacy in healing CAF, showing a better outcome when using nifedipine, than when using other treatments (glyceryl trinitrate or stearate ointment, stool softeners, lidocaine ointment 1.5%, and hydrocortisone acetate ointment 1%). Botulinum toxin compared with other topical treatments showed no superiority in the cure of CAF, as demonstrated by other studies [11,27,45]. The results of this study indicate that the use of botulinum toxin as a primary agent in the treatment of anal fissures is not recommended, instead, it could offer real benefits as a second-line treatment.…”

Perspective Chapter: The Management of Chronic Anal Fissures

“…The results of these two techniques have been studied in multiple opportunities, and in a Cochrane review updated in 2011, similar success and recurrence rates were reported. Fecal incontinence rates are also comparable [14].…”