Evidence map›Paper›PMID 36357803›Full record

SynthesisWorld journal of surgery2023

Can Targeting Sphincter Spasm Reduce Post-Haemorrhoidectomy Pain? A Systematic Review and Meta-Analysis.

James Jin, Hanson Unasa, Praharsh Bahl, Melbourne Mauiliu-Wallis, Darren Svirskis, Andrew Hill

3 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of surgery, 2023. 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 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 13% 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.

NCT07083063 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Precise Endoscopic Application of Nitroglycerin in Preventing Post-ERCP Pancreatitis: A Randomized Controlled Trial

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2025 to 2027Enrolled440ConditionsPancreatitisArmsNitroglycerin (NTG), Normal Saline (0.9% NaCl)
NCT07399860 phase2recruitingnot on this mapstarted 2026, after this paper: background citation

Effect of Internal Anal Sphincter Botulinum Toxin A Injection 7 Days Before Hemorrhoidectomy on Postoperative Pain: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

TypeinterventionalSponsorLomonosov Moscow State University Medical Research and Educational CenterRan2026 to 2028Enrolled292ConditionsHemorrhoids, Postoperative PainArmsBotulinum toxin type A, Saline (0.9% NaCl)
NCT07659665 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Effect of Oral Nifedipine Versus Placebo on Postoperative Pain and Healing Following Hemorrhoidectomy in Adult Patients: A Randomized Controlled Trial in Sana'a, Yemen

TypeinterventionalSponsorSana'a UniversityRan2026 to 2026Enrolled100ConditionsHemorrhoids, Postoperative Pain, Wound Healing, AnalgesiaArmsNifedipine 20 Mg, Placebo
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

James JinDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Level 2, Esme Green Bldg, Middlemore Hospital, Private Bag 93311, Auckland, 1640, New Zealand. James.jin@auckland.ac.nz.ORCID 0000-0001-7027-9906
Hanson UnasaDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Level 2, Esme Green Bldg, Middlemore Hospital, Private Bag 93311, Auckland, 1640, New Zealand.
Praharsh BahlDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Level 2, Esme Green Bldg, Middlemore Hospital, Private Bag 93311, Auckland, 1640, New Zealand.
Melbourne Mauiliu-WallisDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Level 2, Esme Green Bldg, Middlemore Hospital, Private Bag 93311, Auckland, 1640, New Zealand.
Darren SvirskisFaculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand.
Andrew HillDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Level 2, Esme Green Bldg, Middlemore Hospital, Private Bag 93311, Auckland, 1640, New Zealand.
University of Auckland · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHaemorrhoidectomy is often complicated by significant post-operative pain, to which spasm of the internal anal sphincter is thought to be a contributing factor. This study appraises the evidence behind interventions aimed at lowering sphincter spasm to relieve post-haemorrhoidectomy pain.

methodsA Preferred Reporting Items for Systematic Reviews and Meta-analyses compliant systematic review was conducted. Medline, EMBASE, and CENTRAL databases were systematically searched. All RCTs which compared interventions targeting the internal anal sphincter to relieve pain post excisional haemorrhoidectomy were included. The primary outcome measure was pain on the visual analogue scale.

resultsOf the initial 10,221 search results, 39 articles were included in a qualitative synthesis, and 33 studies were included in a meta-analysis. Topical glyceryl trinitrate (GTN) reduced pain on day 7 (7 studies, 485 participants), with a mean difference and 95% confidence interval (MD, 95% CI) of -1.34 (-2.31; -0.37), I

conclusionEvidence suggests that lateral sphincterotomy, administration of botulinum toxin and the application of topical diltiazem or GTN can reduce post-operative pain after haemorrhoidectomy. Lateral sphincterotomy should not be routinely used due to the risk of incontinence.

Indexed as

Botulinum ToxinsHemorrhoidectomyDiltiazemHumansNitroglycerinPostoperative PainSpasmBotulinum ToxinsDiltiazemNitroglycerin

Identifiers

PMID36357803
PMCPMC9803754
OpenAlexW4308771380

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.