The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures

Davids, Jennifer S.; Hawkins, Alexander T.; Bhama, Anuradha R.; Feinberg, Adina; Grieco, Michael J.; Lightner, Amy L.; Feingold, Daniel L.; Paquette, Ian M.

doi:10.1097/dcr.0000000000002664

Cited by 10 publications

(4 citation statements)

References 85 publications

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“…(Figure 4). Recent guidelines from ASCRS are fairly similar; however we have used a more up to date, transparent 'grade' process [6].…”

Section: Discussionmentioning

confidence: 99%

“…There has not been much change in the management algorithm previously identified, however a few modifications have been added (Figure 4). Recent guidelines from ASCRS are fairly similar; however we have used a more up to date, transparent ‘grade’ process [6]. During our review, we identified a group of patients who are clinically minimally symptomatic or asymptomatic, who are happy with their symptoms and do not want further treatment.…”

Section: Discussionmentioning

confidence: 99%

“…It does not include detailed advice for secondary care. The American Society of Colon and Rectal Surgeons guidelines, published in 2017 [5], and the updated guideline in 2023, combine the strength of recommendation with the level of evidence, rating the evidence with strong recommendations and moderate evidence [6]. Within our guideline, we use the 'grade' level of evidence and reflect the strength of the recommendation in our structured wording [7].…”

Section: Introductionmentioning

confidence: 99%

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The Association of Coloproctology of Great Britain and Ireland guideline on the management of anal fissure

Cross,

Brown,

Kleijnen

et al. 2023

Colorectal Disease

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AimThe management of anal fissure: ACPGBI position statement was written 15 years ago. [KLR Cross et al., Colorectal Dis, 2008]. Our aim was to update the guideline and provide recommendations on the most effective treatment for patients with anal fissures utilising a multidisciplinary, rigorous guideline methodology.MethodsThe development process consisted of six phases. In phase 1 we defined the scope of the guideline. The patient population included patients with acute and chronic anal fissure. The target group was all practitioners (primary and secondary care) treating patients with fissures and, in addition, healthcare workers and patients who desired information regarding fissure management. In phase 2 we formed a guideline development group (GDG) including a methodologist. In phase 3 review questions were formulated, using a reversed PICO process, starting with possible recommendations based on the GDG's knowledge. In phase 4 a comprehensive literature search focused on existing systematic reviews addressing each review question, supplemented by more recent studies if appropriate. In phase 5 data were extracted from the included papers and checked by the GDG. If indicated, meta‐analysis of systematic review data was updated by the GDG. During phase 6 the GDG members decided what recommendations could be made based on the evidence in the literature and strength of the recommendation was assessed using ‘grade’.ResultsThis guideline is divided into two sections: Primary care which includes (i) diagnosis; (ii) basic treatment; (iii) topical treatment; and secondary care which includes (iv) botulinum toxin therapy; (v) surgical intervention and (vi) special situations (including pregnancy and breast‐feeding patients, children, receptive anal intercourse and low‐pressure fissures). A total of 23 recommendations were formulated. A new term clinically healed was described by the GDG.ConclusionThis guideline provides an up‐to‐date evidence‐based summary of the current knowledge of the management of anal fissure and may serve as a useful guide for clinicians as well as a potential reference for patients.

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“…(Figure 4). Recent guidelines from ASCRS are fairly similar; however we have used a more up to date, transparent 'grade' process [6].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Association of Coloproctology of Great Britain and Ireland guideline on the management of anal fissure

Cross,

Brown,

Kleijnen

et al. 2023

Colorectal Disease

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show abstract

“…We read with great interest the recent "Clinical Guidelines for the Management of Anal Fissures. " 1 Despite the unquestionably valuable information provided, we have some questions for the authors about specific aspects of the article.…”

Section: On Practice Guidelines For the Management Of Anal Fissuresmentioning

confidence: 99%

On Practice Guidelines for the Management of Anal Fissures

Damin

Contu

2023

Diseases of the Colon &Amp; Rectum

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Surgeons’ practice and preferences for the anal fissure treatment: results from an international survey

Balla,

Saraceno,

Shalaby

et al. 2023

Updates Surg

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures

Abstract: Earn Continuing Education (CME) credit online at cme.lww.com. This activity has been approved for AMA PRA Category 1 credit.Funding/Support: None reported.

Cited by 10 publications

References 85 publications

The Association of Coloproctology of Great Britain and Ireland guideline on the management of anal fissure

The Association of Coloproctology of Great Britain and Ireland guideline on the management of anal fissure

On Practice Guidelines for the Management of Anal Fissures

Surgeons’ practice and preferences for the anal fissure treatment: results from an international survey

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