Trial reportLangenbeck's archives of surgery2012
Botulinum toxin injection versus lateral internal sphincterotomy for the treatment of chronic anal fissure: randomized prospective controlled trial.
Trial report in Langenbeck's archives of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 19 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Comparative Efficacy and Safety Study of Lateral Subcutaneous Sphincterotomy and Botulinum Toxin Type A in the Treatment of Chronic Anal Fissure
Effects of Platelet-rich Plasma in the Treatment of Chronic Anal Fissure
Botulinum Toxin Type A in the Treatment of Chronic Anal Fissure Without Excision
Combined Method of Surgical Treatment of Anal Fissure
Who cites it
19 citing papers in PubMed, 6 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- The role of percutaneous tibial nerve stimulation (PTNS) in the treatment of chronic anal fissure: a systematic review.International journal of colorectal disease · 2021Pooled it
- Management options for chronic anal fissure: a systematic review of randomised controlled trials.International journal of colorectal disease · 2020Pooled it
- A systematic review and meta-analysis of the treatment of anal fissure.Techniques in coloproctology · 2017Pooled it
- Botulinum Toxin Injection for Treatment of Chronic Anal Fissure: Is There Any Dose-Dependent Efficiency? A Meta-Analysis.World journal of surgery · 2016Pooled it
- Anal fissure (chronic).BMJ clinical evidence · 2014Pooled it
- Botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials.Techniques in coloproctology · 2014Pooled it
- Gastrointestinal Uses of Botulinum Toxin.Handbook of experimental pharmacology · 2021Trial
- Injection of botulinum toxin significantly increases efficiency of fissurectomy in the treatment of chronic anal fissures.International journal of colorectal disease · 2022Article
- Comparison of botulinum toxin (BoNT) injection and lateral internal sphincterotomy (redo-LIS) for recurrent anal fissure treatment.Frontiers in surgery · 2022Article
- Incidence of anal incontinence among patients with anal fissure treated with Botox injection versus lateral sphincterotomy.Annals of medicine and surgery (2012) · 2021Article
- Botulinum Toxin A: A Review of Potential Uses in Treatment of Female Urogenital and Pelvic Floor Disorders.Ochsner journal · 2020Review
- Anal stretch for chronic anal fissure: an old operation that stood the test of time.Langenbeck's archives of surgery · 2019Article
- Operative and medical treatment of chronic anal fissures-a review and network meta-analysis of randomized controlled trials.Journal of gastroenterology · 2017Review
- Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study.Annals of medicine and surgery (2012) · 2017Article
- Lateral Anal Sphincterotomy for Chronic Anal Fissures- A Comparison of Outcomes and Complications under Local Anaesthesia Versus Spinal Anaesthesia.Journal of clinical and diagnostic research : JCDR · 2017Article
- Are we following an algorithm for managing chronic anal fissure? A completed audit cycle.Annals of medicine and surgery (2012) · 2016Article
- Review
- Botulinum toxin for conditions of the female pelvis.International urogynecology journal · 2013Review
- Botulinum toxin improves pain in chronic anal fissure.Porto biomedical journalArticle
Corrections and comments
- Commented on by
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLateral internal sphincterotomy has been the gold standard treatment for chronic anal fissure, but it still carries the risk of permanent damage of the anal sphincter, which has led to the implementation of alternative treatment like botulinum toxin injection. The aim of this randomized prospective controlled trial was to compare the efficacy and morbidity of botulinum toxin injection and lateral internal sphincterotomy in the treatment of chronic anal fissure.
methodsFifty consecutive adults with chronic anal fissure were randomly treated with either lateral internal sphincterotomy or botulinum toxin (BT) injection with 50 U BT into the internal sphincter. The complications, healing and recurrence rate, and incontinence score were assessed 2, 3, 6, 12 months after the procedure.
resultsInspection at the 2-month visit revealed complete healing of the fissure in 11 (44 %) of the patients in the BT group and 22 (88 %) of the patients in the lateral internal sphincterotomy (LIS) group (p = 0.001). At the 3-month visit, there was no significant difference between the two groups in healing. The overall recurrence rate after 6 months in the BT group was higher than in the LIS group (p < 0.05). In the 3-month follow-up, the LIS group had a higher rate of anal incontinence compared to the BT group (p < 0.05). The final percentage of incontinence was 4 % in the LIS group (p > 0.05).
conclusionsThe treatment of chronic anal fissure must be individualized depending on the different clinical profiles of patients. Botulinum toxin injection has a higher recurrence rate than LIS, and LIS provides rapid and permanent recovery. However, LIS carries a higher risk of anal incontinence in patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.