دورية أكاديمية
أعرض في EDS

A systematic review and meta-analysis of the treatment of anal fissure.

التفاصيل البيبلوغرافية
العنوان: A systematic review and meta-analysis of the treatment of anal fissure.
المؤلفون: Nelson RL; Epidemiology/Biometry Division, University of Illinois School of Public Health, 1603 West Taylor Room 956, Chicago, IL, 60612, USA. altohorn@uic.edu., Manuel D; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Gumienny C; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Spencer B; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Patel K; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Schmitt K; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Castillo D; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Bravo A; Honors College, University of Illinois at Chicago, Chicago, IL, USA., Yeboah-Sampong A; Honors College, University of Illinois at Chicago, Chicago, IL, USA.
المصدر: Techniques in coloproctology [Tech Coloproctol] 2017 Aug; Vol. 21 (8), pp. 605-625. Date of Electronic Publication: 2017 Aug 09.
نوع المنشور: Journal Article; Meta-Analysis; Review; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 9613614 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1128-045X (Electronic) Linking ISSN: 11236337 NLM ISO Abbreviation: Tech Coloproctol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2001->: Milano, Italy : Springer-Verlag Italia
Original Publication: Rome : UCP Club,
مواضيع طبية MeSH: Sphincterotomy*/adverse effects, Anal Canal/*surgery , Fissure in Ano/*therapy, Calcium Channel Blockers/therapeutic use ; Fecal Incontinence/etiology ; Humans ; Nitroglycerin/therapeutic use ; Randomized Controlled Trials as Topic ; Vasodilator Agents/therapeutic use
مستخلص: Background: Anal fissure has a very large number of treatment options. The choice is difficult. In an effort to assist in that, choice presented here is a systematic review and meta-analysis of all published treatments for anal fissure that have been studied in randomized controlled trials.
Methods: Randomized trials were sought in the Cochrane Controlled Trials Register, Medline, EMBASE and the trials registry sites clinicaltrials.gov and who/int/ictrp/search/en. Abstracts were screened, full-text studies chosen, and finally eligible studies selected and abstracted. The review was then divided into those studies that compared two or more surgical procedures and those that had at least one arm that was non-surgical. Studies were further categorized by the specific interventions and comparisons. The outcome assessed was treatment failure. Negative effects of treatment assessed were headache and anal incontinence. Risk of bias was assessed for each study, and the strength of the evidence of each comparison was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
Results: One hundred and forty-eight eligible trials were found and assessed, 31 in the surgical group and 117 in the non-surgical group. There were 14 different operations described in the surgical group and 29 different non-surgical treatments in the non-surgical group along with partial lateral internal sphincterotomy (LIS). There were 61 different comparisons. Of these, 47 were reported in 2 or fewer studies, usually with quite small patient samples. The largest single comparison was glyceryl trinitrate (GTN) versus control with 19 studies. GTN was more effective than control in sustained cure (OR 0.68; 95% CI 0.63-0.77), but the quality of evidence was very poor because of severe heterogeneity, and risk of bias due to inadequate clinical follow-up. The only comparison to have a GRADE quality of evidence of high was a subgroup analysis of LIS versus any medical therapy (OR 0.12; CI 0.07-0.21). Most of the other studies were downgraded in GRADE due to imprecision.
Conclusions: LIS is superior to non-surgical therapies in achieving sustained cure of fissure. Calcium channel blockers were more effective than GTN and with less risk of headache, but with only a low quality of evidence. Anal incontinence, once thought to be a frequent risk with LIS, was found in various subgroups in this review to have a risk between 3.4 and 4.4%. Among the surgical studies, manual anal stretch performed worse than LIS in the treatment of chronic anal fissure in adults. For those patients requiring surgery for anal fissure, open LIS and closed LIS appear to be equally efficacious, with a moderate GRADE quality of evidence. All other GRADE evaluations of procedures were low to very low due mostly to imprecision.
References: S Afr J Surg. 2010 Feb;48(1):20-2. (PMID: 20496820)
Br J Surg. 1989 May;76(5):431-4. (PMID: 2736353)
Langenbecks Arch Chir. 1976 Dec 22;343(1):35-44. (PMID: 1011909)
Cochrane Database Syst Rev. 2011 Nov 09;(11):CD002199. (PMID: 22071803)
Dis Colon Rectum. 1979 Jul-Aug;22(5):308-11. (PMID: 467194)
Eur J Surg. 2002;168(7):418-21. (PMID: 12463433)
Indian J Gastroenterol. 2001 May-Jun;20(3):101-2. (PMID: 11400799)
Tech Coloproctol. 2005 Jul;9(2):115-8. (PMID: 16007364)
ANZ J Surg. 2006 Aug;76(8):718-21. (PMID: 16916391)
Dis Colon Rectum. 2008 Jan;51(1):121-7. (PMID: 18080713)
Dis Colon Rectum. 2015 Jul;58(7):623-36. (PMID: 26200676)
Acta Med Iran. 2016 Jul;54(7):437-40. (PMID: 27424014)
Int J Surg. 2009 Jun;7(3):228-31. (PMID: 19361582)
Dis Colon Rectum. 1980 Jan-Feb;23(1):31-6. (PMID: 7379649)
Am J Gastroenterol. 2006 Sep;101(9):2107-12. (PMID: 16848808)
Int J Colorectal Dis. 2012 Jan;27(1):1-9. (PMID: 21822595)
Colorectal Dis. 2014 Mar;16(3):159-66. (PMID: 24521273)
Int J Colorectal Dis. 2006 Mar;21(2):179-83. (PMID: 16091912)
Tech Coloproctol. 2010 Sep;14(3):241-8. (PMID: 20632059)
Br J Surg. 2002 Apr;89(4):413-7. (PMID: 11952579)
N Engl J Med. 1999 Jul 8;341(2):65-9. (PMID: 10395629)
Lancet. 1997 Jan 4;349(9044):11-4. (PMID: 8988115)
Am J Surg. 2000 Jan;179(1):46-50. (PMID: 10737578)
Med Sci Monit. 2003 Oct;9(10):PI123-6. (PMID: 14523338)
Dis Colon Rectum. 2003 Jun;46(6):805-8. (PMID: 12794583)
Int J Colorectal Dis. 2009 Apr;24(4):461-4. (PMID: 19137320)
World J Surg. 2010 Nov;34(11):2730-4. (PMID: 20703472)
Dis Colon Rectum. 2004 Jun;47(6):847-52. (PMID: 15129311)
Arch Dis Child. 2001 Nov;85(5):404-7. (PMID: 11668104)
S Afr Med J. 1951 Jul 14;25(28):486-9. (PMID: 14866486)
J Gastrointest Surg. 2009 Jul;13(7):1279-82. (PMID: 19415396)
Malays J Med Sci. 2015 Sep;22(5):42-49. (PMID: 28239267)
J Gastrointest Surg. 2009 Jul;13(7):1283-91. (PMID: 19367435)
Bangladesh Med Res Counc Bull. 2008 Apr;34(1):12-5. (PMID: 18783071)
Chir Ital. 2006 Nov-Dec;58(6):761-5. (PMID: 17190281)
Dis Colon Rectum. 2004 Apr;47(4):437-43. (PMID: 14994114)
Pediatr Surg Int. 2012 Apr;28(4):411-6. (PMID: 22212494)
Dis Colon Rectum. 2015 Feb;58(2):228-34. (PMID: 25585082)
Int J Colorectal Dis. 2000 Aug;15(4):243-5. (PMID: 11008725)
N Z Med J. 2014 May 02;127(1393):80-6. (PMID: 24816958)
Dis Colon Rectum. 1997 Jul;40(7):840-5. (PMID: 9221864)
J Gastrointest Surg. 2012 Oct;16(10):1955-62. (PMID: 22869534)
Acta Med Iran. 2010 Sep-Oct;48(5):295-9. (PMID: 21287460)
Dis Colon Rectum. 2004 Jul;47(7):1170-3. (PMID: 15148646)
Colorectal Dis. 2008 Jul;10(6):547-52. (PMID: 17868402)
Colorectal Dis. 1999 Jan;1(1):26-8. (PMID: 23577680)
Br J Surg. 1983 Jan;70(1):25-6. (PMID: 6337670)
Dig Liver Dis. 2015 Aug;47(8):628-45. (PMID: 25937624)
Dis Colon Rectum. 1996 Apr;39(4):440-3. (PMID: 8878506)
Dis Colon Rectum. 2000 Aug;43(8):1048-57; discussion 1057-8. (PMID: 10950002)
Aliment Pharmacol Ther. 2003 Sep 1;18(5):515-24. (PMID: 12950424)
Br Med J (Clin Res Ed). 1986 May 3;292(6529):1167-9. (PMID: 3011180)
Aliment Pharmacol Ther. 2002 Jan;16(1):101-3. (PMID: 11856083)
World J Surg. 2007 Oct;31(10):2052-7. (PMID: 17665247)
Eur J Surg. 2001 May;167(5):382-5. (PMID: 11419556)
Tech Coloproctol. 2007 Dec 3;:null. (PMID: 18060530)
ANZ J Surg. 2005 Dec;75(12):1032-5. (PMID: 16398803)
Arq Gastroenterol. 2009 Jul-Sep;46(3):179-82. (PMID: 19918682)
Br J Surg. 1983 Mar;70(3):175-6. (PMID: 6338993)
Indian J Gastroenterol. 2004 May-Jun;23(3):91-3. (PMID: 15250565)
Surg Today. 2007;37(6):482-5. (PMID: 17522765)
Asian J Surg. 2014 Oct;37(4):178-83. (PMID: 24637183)
Int J Surg. 2015 Oct;22:143-8. (PMID: 26316154)
Acta Chir Belg. 2006 Jan-Feb;106(1):55-8. (PMID: 16612915)
Harefuah. 2004 Oct;143(10):713-7, 767, 766. (PMID: 15521346)
Ann Surg. 2012 Jan;255(1):18-22. (PMID: 21685792)
J Clin Diagn Res. 2014 Oct;8(10):NC01-2. (PMID: 25478389)
Dis Colon Rectum. 1992 Sep;35(9):835-7. (PMID: 1511641)
Colorectal Dis. 2007 Jul;9(6):549-52. (PMID: 17573751)
Colorectal Dis. 2013 Jan;15(1):19-26. (PMID: 22487078)
Cochrane Database Syst Rev. 2012 Feb 15;(2):CD003431. (PMID: 22336789)
Dis Colon Rectum. 1997 Nov;40(11):1318-20. (PMID: 9369106)
Dis Colon Rectum. 2008 Jul;51(7):1079-83. (PMID: 18470565)
Int J Surg. 2007 Dec;5(6):429-32. (PMID: 17869598)
Dis Colon Rectum. 1999 Aug;42(8):1011-5. (PMID: 10458123)
Aliment Pharmacol Ther. 2004 Mar 15;19(6):695-701. (PMID: 15023172)
Colorectal Dis. 2008 Nov;10 Suppl 3:1-7. (PMID: 18954306)
Eur Rev Med Pharmacol Sci. 2005 May-Jun;9(3):175-8. (PMID: 16080637)
Gastroenterology. 2003 Jan;124(1):233-4. (PMID: 12512045)
Eur J Surg Suppl. 2003 Jul;(588):18-22. (PMID: 15200038)
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Jul;16(7):654-7. (PMID: 23888450)
Zhong Xi Yi Jie He Xue Bao. 2011 Apr;9(4):402-9. (PMID: 21486553)
Ann Ital Chir. 2009 Sep-Oct;80(5):379-83. (PMID: 20131551)
Colorectal Dis. 2014 Oct;16(10):O360-6. (PMID: 24629060)
Am Surg. 1992 Nov;58(11):705-9. (PMID: 1485705)
Indian J Surg. 2015 Dec;77(Suppl 3):1484-7. (PMID: 27011607)
Colorectal Dis. 2002 Sep;4(5):317-320. (PMID: 12780574)
J Clin Epidemiol. 2011 Dec;64(12):1294-302. (PMID: 21803546)
Dis Colon Rectum. 2008 Mar;51(3):329-33. (PMID: 18176828)
Indian J Surg. 2011 Aug;73(4):268-77. (PMID: 22851840)
J R Soc Med. 1987 May;80(5):296-8. (PMID: 3039130)
Biomed Res Int. 2014;2014:964942. (PMID: 25089280)
Chirurg. 2015 Aug;86(8):734-40. (PMID: 25956532)
Am J Gastroenterol. 2014 Aug;109(8):1141-57; (Quiz) 1058. (PMID: 25022811)
J Med Liban. 1999 May-Jun;47(3):164-8. (PMID: 10550940)
Tech Coloproctol. 2003 Oct;7(3):155-8. (PMID: 14628158)
Indian J Gastroenterol. 2005 Jul-Aug;24(4):158-60. (PMID: 16204903)
Dis Colon Rectum. 2002 Sep;45(9):1192-9. (PMID: 12352236)
Asian J Surg. 2014 Jan;37(1):15-9. (PMID: 23972505)
Dis Colon Rectum. 2017 Jan;60(1):81-86. (PMID: 27926561)
Surg Today. 2010 Aug;40(8):752-6. (PMID: 20676860)
Am J Surg. 2013 Nov;206(5):748-51. (PMID: 24035211)
Int J Colorectal Dis. 2008 Jan;23(1):1-6. (PMID: 17846781)
Br J Surg. 2007 Feb;94(2):162-7. (PMID: 17256809)
Surgery. 2002 Feb;131(2):179-84. (PMID: 11854696)
Dis Colon Rectum. 2001 Aug;44(8):1074-8. (PMID: 11535842)
Dis Colon Rectum. 2008 Jan;51(1):128-33. (PMID: 18085337)
J Clin Epidemiol. 2011 Dec;64(12):1283-93. (PMID: 21839614)
Tech Coloproctol. 2001 Dec;5(3):143-7. (PMID: 11875681)
Int J Colorectal Dis. 1987 Aug;2(3):155-7. (PMID: 3655512)
Dis Colon Rectum. 2006 Dec;49(12):1822-30. (PMID: 17096178)
J Pediatr Surg. 2002 Sep;37(9):1313-6. (PMID: 12194122)
Acta Med Croatica. 2008 Feb;62(1):73-80. (PMID: 18365505)
Indian J Gastroenterol. 2015 Mar;34(2):152-7. (PMID: 25925729)
Langenbecks Arch Surg. 2012 Oct;397(7):1093-8. (PMID: 22430300)
Dis Colon Rectum. 2005 Feb;48(2):365-70. (PMID: 15711861)
Asian J Surg. 2013 Oct;36(4):165-9. (PMID: 24054756)
Dis Colon Rectum. 2006 Jun;49(6):865-8. (PMID: 16614779)
Dis Colon Rectum. 1995 Jan;38(1):69-71. (PMID: 7813349)
Ayu. 2014 Apr;35(2):141-7. (PMID: 25558158)
Dis Colon Rectum. 2001 Jan;44(1):93-7. (PMID: 11805569)
Dis Colon Rectum. 2006 Apr;49(4):427-32. (PMID: 16456637)
Colorectal Dis. 2013 Mar;15(3):e104-17. (PMID: 23320551)
Br J Surg. 2005 Apr;92(4):403-8. (PMID: 15739214)
Br J Surg. 2009 Dec;96(12):1393-9. (PMID: 19918859)
Br J Surg. 1984 May;71(5):360-2. (PMID: 6722464)
Surg Today. 2013 May;43(5):500-5. (PMID: 22961196)
ANZ J Surg. 2005 Jul;75(7):553-5. (PMID: 15972045)
Dis Colon Rectum. 2000 Feb;43(2):174-9; discussion 179-81. (PMID: 10696890)
Colorectal Dis. 2008 Jul;10(6):541-6. (PMID: 17868403)
Acta Gastroenterol Belg. 2002 Oct-Dec;65(4):187-90. (PMID: 12619423)
J Clin Epidemiol. 2011 Apr;64(4):383-94. (PMID: 21195583)
N Engl J Med. 1998 Jan 22;338(4):217-20. (PMID: 9435326)
Colorectal Dis. 2003 May;5(3):256-7. (PMID: 12780888)
Trop Gastroenterol. 2010 Jan-Mar;31(1):69-71. (PMID: 20860238)
Dis Colon Rectum. 2003 Feb;46(2):232-7. (PMID: 12576897)
Dis Colon Rectum. 2006 Oct;49(10):1574-80. (PMID: 16988850)
Am J Gastroenterol. 2013 May;108(5):825-32. (PMID: 23588240)
Dis Colon Rectum. 1987 Jun;30(6):420-3. (PMID: 3297566)
J Am Coll Surg. 2004 Sep;199(3):361-7. (PMID: 15325604)
Colorectal Dis. 2001 May;3(3):165-8. (PMID: 12790983)
Dis Colon Rectum. 1999 Aug;42(8):1000-6. (PMID: 10458121)
Dis Colon Rectum. 2010 Aug;53(8):1110-5. (PMID: 20628272)
Dis Colon Rectum. 2004 Jan;47(1):35-8. (PMID: 14719148)
Br Med J (Clin Res Ed). 1984 Sep 1;289(6444):528-30. (PMID: 6432173)
Am J Surg. 2005 Apr;189(4):429-34. (PMID: 15820455)
Dis Colon Rectum. 1985 Nov;28(11):832-5. (PMID: 4053894)
Zhong Xi Yi Jie He Xue Bao. 2005 May;3(3):190, 206. (PMID: 15885164)
Gut. 1999 May;44(5):727-30. (PMID: 10205213)
J Coll Physicians Surg Pak. 2009 Oct;19(10):614-7. (PMID: 19811710)
Acta Gastroenterol Belg. 2012 Dec;75(4):438-42. (PMID: 23402088)
Dis Colon Rectum. 2002 Nov;45(11):1468-75. (PMID: 12432293)
East Afr Med J. 1992 Nov;69(11):613-5. (PMID: 1298616)
S Afr J Surg. 2009 Nov;47(4):112-4. (PMID: 20141067)
Gut. 2003 Feb;52(2):264-9. (PMID: 12524411)
Tech Coloproctol. 2004 Aug;8(2):89-92; discussion 92-3. (PMID: 15309644)
J Pediatr Surg. 1999 Dec;34(12):1810-2. (PMID: 10626860)
فهرسة مساهمة: Keywords: Anal fissure; Medical therapy; Meta-analysis; Sphincterotomy
المشرفين على المادة: 0 (Calcium Channel Blockers)
0 (Vasodilator Agents)
G59M7S0WS3 (Nitroglycerin)
تواريخ الأحداث: Date Created: 20170811 Date Completed: 20180816 Latest Revision: 20181202
رمز التحديث: 20221213
DOI: 10.1007/s10151-017-1664-2
PMID: 28795245
قاعدة البيانات: MEDLINE
الوصف
تدمد:1128-045X
DOI:10.1007/s10151-017-1664-2