SynthesisWorld journal of surgery2016
Botulinum Toxin Injection for Treatment of Chronic Anal Fissure: Is There Any Dose-Dependent Efficiency? A Meta-Analysis.
Synthesis in World journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 19 papers, 1 of them a synthesis 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
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, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Botulinum toxin injections after surgery for Hirschsprung disease: Systematic review and meta-analysis.World journal of gastroenterology · 2019Pooled it
- Early botulinum toxin injection reduces pain after hemorrhoidectomy: a pilot study.Techniques in coloproctology · 2022Trial
- Botulinum toxin A injection for chronic anal fissure: A retrospective observational study.Medicine · 2026Observational
- Dysphagia and Muscle Weakness Caused by Botulinum Toxin Poisoning after Cosmetic Injection: Three Case Reports and Clinical Warnings.Dysphagia · 2025Review
- The 5-year outcomes and predictors of healing in chronic anal fissure treated with botulinum toxin: a retrospective analysis of 199 cases.Techniques in coloproctology · 2025Article
- Management of chronic anal fissures: should fissurectomy be performed with botulinum toxin injection?Techniques in coloproctology · 2025Article
- Comparative Analysis of Open and Closed Sphincterotomy for the Treatment of Chronic Anal Fissure: Safety and Efficacy Evaluation.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Assessment of Quality of Life in Patients with Chronic Anal Fissures: A 1-Year Follow-Up Study before and after Botulinum Toxin (Botox) Injection.Journal of clinical medicine · 2024Article
- High-Intensity Laser Therapy - An Option for Managing the Pain in Anal Fissures.Journal of lasers in medical sciences · 2024Article
- An Update of Pharmacological Management in Children with Functional Constipation.Paediatric drugs · 2023Review
- Botulinum Toxin A Use in the Gastrointestinal Tract: A Reappraisal After Three Decades.Gastroenterology & hepatology · 2023Article
- Effectiveness of Local Botulinum Toxin Injection for Perianal Pain after Hemorrhoidectomy.Middle East journal of digestive diseases · 2022Article
- Off-Label Use of Botulinum Toxin in Dermatology-Current State of the Art.Molecules (Basel, Switzerland) · 2022Review
- Botulinum toxin injection for the treatment of chronic anal fissure: uni- and multivariate analysis of the factors that promote healing.International journal of colorectal disease · 2022Article
- Perianal Hyperhidrosis Successfully Treated with Botulinum Toxin A.Skin appendage disorders · 2021Article
- Evaluation of practice patterns of chemodenervation for anal fissure of the ASCRS young surgeons.Techniques in coloproctology · 2020Article
- Therapeutic properties of botulinum toxin on chronic anal fissure treatment and the patient factors role.Journal of family medicine and primary care · 2020Article
- Botox treatment in patients with chronic functional anorectal pain: experiences of a tertiary referral proctology clinic.Techniques in coloproctology · 2019Article
- High-dose versus low-dose botulinum toxin in anal fissure disease.Techniques in coloproctology · 2017Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic anal fissure (CAF) is a linear split of the anoderm. The minimally invasive management of CAF such as botulinum toxin (BT) injection is recommended. However, the exact efficient dose of BT, number of injections per session and the injection sites are still debatable. The aim of this analysis was to assess the dose-dependent efficiency of botulinum toxin injection for CAF.
methodsPubMed and Web of Science databases were searched for terms: "anal fissure" AND "botulinum toxin." Studies published between October 1993 and May 2015 were included and had to meet the following criteria: (1) chronic anal fissure, (2) prospective character of the study, (3) used simple BT injection without any other interventions and (4) no previous treatment with BT.
resultsA total of 1577 patients from 34 prospective studies used either Botox or Dysport formulations were qualified for this meta-analysis. A total number of BT units per session ranged from 5 to 150 IU, whereas the efficiency across analyzed studies ranged from 33 to 96 %. Surprisingly, we did not observe a dose-dependent efficiency (Spearman's rank correlation coefficient, ρ = 0.060; p = 0.0708). Moreover, there were no BT dose-dependent postoperative complications or fecal incontinence and significant difference in healing rates compared BT injection into the anal sphincter muscles.
conclusionsBT injection has been an accepted method for the management of CAF. Surprisingly, there is no dose-dependent efficiency, and the postoperative incontinence rate is not related to the BT dosage regardless the type of formulation of botulinum neurotoxin used. Moreover, no difference in healing rate has been observed in regard to the site and number of injections per session.
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.