Evidence map›Paper›PMID 24500725›Full record

SynthesisTechniques in coloproctology2014

Botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials.

H-L Chen, X-B Woo, H-S Wang, Y-J Lin, H-X Luo, Y-H Chen, C-Q Chen, J-S Peng

3 registry-linked trialsAbstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
6.5field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03855046 phase4recruitingnot on this mapstarted 2019, after this paper: background citation

A Comparative Efficacy and Safety Study of Lateral Subcutaneous Sphincterotomy and Botulinum Toxin Type A in the Treatment of Chronic Anal Fissure

TypeinterventionalSponsorState Scientific Centre of Coloproctology, Russian FederationRan2019 to 2022Enrolled340ConditionsFissure in AnoArmsIncobotulinumtoxinA 50 U Intramuscular Powder for Solution, Lateral subcutaneous sphincterotomy.
NCT05598164 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Botulinum Toxin Type A in the Treatment of Chronic Anal Fissure Without Excision

TypeinterventionalSponsorState Scientific Centre of Coloproctology, Russian FederationRan2022 to 2025Enrolled140ConditionsChronic Anal FissureArmsBotulinum toxin type A
NCT07268261 narecruitingnot on this mapstarted 2023, after this paper: background citation

Combined Method of Surgical Treatment of Anal Fissure

TypeinterventionalSponsorState Scientific Centre of Coloproctology, Russian FederationRan2023 to 2026Enrolled122ConditionsChronic Anal FissureArmsexcision of the anal fissure with further relaxation of the internal sphincter with botulinum toxin A
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.

  1. Pooled it
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  5. Gastrointestinal Uses of Botulinum Toxin.Handbook of experimental pharmacology · 2021
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  11. Problems with repairing gut sphincters malfunctions.World journal of gastrointestinal surgery · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

H-L ChenDepartment of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, No. 26 Yuancun Er Heng Rd, Tianhe District, Guangzhou, 510655, Guangdong Province, People's Republic of China.
X-B Woo
H-S Wang
Y-J Lin
H-X Luo
Y-H Chen
C-Q Chen
J-S Peng
Sun Yat-sen University · CNSixth Affiliated Hospital of Sun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough surgery is the gold standard treatment for anal fissure, the main concern remains its side effects and complications. Botulinum toxin injection and lateral internal sphincterotomy are technical options for patients suffering from chronic anal fissure. However, little is known about the efficacy of these two techniques. The aim of this meta-analysis was to compare the outcomes of botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure.

methodsOriginal studies in English were searched from the MEDLINE database, PubMed, Web of Science, and the Cochrane Library database. Randomized control trials that compared botulinum toxin injection with lateral internal sphincterotomy were identified. Data were independently extracted for each study, and a meta-analysis was performed using fixed and random effects models.

resultsFour hundred and eighty-nine patients from seven trials met the inclusion criteria. Patients undergoing lateral internal sphincterotomy had a higher-healing and incontinence rate. No statistically significant differences were noted in total complications between botulinum toxin injection and lateral internal sphincterotomy. Patients treated with lateral internal sphincterotomy had a significantly lower recurrence rate than the patients treated with botulinum toxin injection.

conclusionsOur meta-analysis shows that lateral internal sphincterotomy was superior to botulinum toxin injection in terms of healing rate and lower recurrence rate. Botox, however, is safe associated with a lower rate of incontinence and could be used in certain situations. Further studies with a long-term follow-up are required to confirm our observations.

Indexed as

Randomized Controlled Trials as TopicAcetylcholine Release InhibitorsAnal CanalBotulinum Toxins, Type AChronic DiseaseDigestive System Surgical ProceduresFissure in AnoHumansTreatment OutcomeAcetylcholine Release InhibitorsBotulinum Toxins, Type A

Identifiers

PMID24500725
OpenAlexW2026726872

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.