2022
DOI: 10.1016/j.surg.2021.11.030
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A systematic review and network meta-analysis comparing treatments for anal fissure

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Cited by 20 publications
(15 citation statements)
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“…This meta‐analysis reported lateral internal sphincterotomy to be effective in reducing pain. Sphincterotomy remains the most effective treatment for chronic anal fissure; however, anal incontinence remains a risk as a recent meta‐analysis showed incontinence rates estimated at 6% across all randomised controlled trials [6]. Alternative, safer options include botulinum toxin administration as well as topical therapies.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…This meta‐analysis reported lateral internal sphincterotomy to be effective in reducing pain. Sphincterotomy remains the most effective treatment for chronic anal fissure; however, anal incontinence remains a risk as a recent meta‐analysis showed incontinence rates estimated at 6% across all randomised controlled trials [6]. Alternative, safer options include botulinum toxin administration as well as topical therapies.…”
Section: Discussionmentioning
confidence: 99%
“…After excisional haemorrhoidectomy, patients develop linear wounds that extend up to the anorectal ring at the site of the vascular pedicle [5]. The appearance of these wounds is similar to that of a fissure‐in‐ano, where hypertonia of the internal anal sphincter has been associated with anal fissure [6, 7]. It is believed that spasm of hypertonia of the internal sphincter is responsible for the discomfort after haemorrhoidectomy, especially during defecation.…”
Section: Introductionmentioning
confidence: 99%
“…The main issue with LIS has been the risk of incontinence [45]. Garg et al have reported incontinence rates as 14% during a follow-up of 2 years [46].…”
Section: Techniques Of Lateral Internal Sphincterotomymentioning
confidence: 99%
“…A recently published extensive systematic review and network meta-analysis, whilst not specifically assessing advancement flap, concluded that an advancement flap shows similar effectiveness compared to lateral sphincterotomy, but more studies are needed to evaluate its efficacy [44]. The review also has a high risk of bias.…”
Section: Grade Of Evidence: Very Lowmentioning
confidence: 99%