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

dc.contributor.authorBonyad, Ali
dc.contributor.authorZadeh, Reza Hossein
dc.contributor.authorAsgari, Setareh
dc.contributor.authorEghbal, Fatemeh
dc.contributor.authorHajhosseini, Pardis
dc.contributor.authorShahhosseini, Reza
dc.contributor.authorSeyedipour, Sina
dc.date.accessioned2025-11-24T12:07:11Z
dc.date.available2025-11-24T12:07:11Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi
dc.description.abstractBackground: Anal fissures, tears in the epithelium of the anal canal that cause pain and bleeding, have a lifetime prevalence of 11%. While surgical treatments, such as lateral internal sphincterotomy are traditional, they pose postoperative complications. Recent studies investigated less invasive options involving botulinum toxin injection, showing promise with fewer adverse effects. The aim of this study is to compare the outcomes of botulinum toxin injection to lateral internal sphincterotomy for chronic anal fissures. Method: Up to October 2023, an extensive literature search was conducted in PubMed, Scopus, and Google Scholar to identify relevant papers. This systematic review and meta-analysis examined the comparative effectiveness of lateral internal sphincterotomy and botulinum toxin injection in the treatment of chronic anal fissures. The methodology adheres to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, and the study protocol has been registered with the Open Science Framework (OSF). Results: A total of 1,839 patients from 18 trials were included in the meta-analysis. Patients undergoing lateral internal sphincterotomy had higher healing compared to botulinum toxin injection (pooled effect = 0.77; 95% CI= [0.69– 0.83]; I2 = 90.95%; P = 0.00). Conclusion: Our study revealed the efficacy of lateral internal sphincterotomy over botulinum toxin injection in promoting healing for chronic anal fissures. These findings emphasize the clinical advantage of traditional surgical interventions in the management of this condition. However, further studies with long-term follow-up are required to confirm our observations.
dc.identifier.citationBonyad, A., Zadeh, R. H., Asgari, S., Eghbal, F., Hajhosseini, P., Shahhosseini, R. ... Seyedipour, S. (2024). Botulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials. Langenbeck's Archives of Surgery, 409(1). http://dx.doi.org/10.1007/s00423-024-03484-9
dc.identifier.doi10.1007/s00423-024-03484-9
dc.identifier.issn1435-2443
dc.identifier.issn1435-2451
dc.identifier.issue1
dc.identifier.pmid39579232
dc.identifier.scopus2-s2.0-85210014906
dc.identifier.scopusqualityQ2
dc.identifier.urihttp://dx.doi.org/10.1007/s00423-024-03484-9
dc.identifier.urihttps://hdl.handle.net/20.500.12511/13234
dc.identifier.volume409
dc.identifier.wosWOS:001361513900002
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorShahhosseini, Reza
dc.language.isoen
dc.relation.ispartofLangenbeck's Archives of Surgery
dc.relation.publicationcategoryDiğer
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAnal Fissure
dc.subjectBotulinum Toxin
dc.subjectBotulism
dc.subjectLateral Internal Sphincterotomy
dc.subjectMeta-Analysis
dc.titleBotulinum toxin injection versus lateral internal sphincterotomy for chronic anal fissure: a meta-analysis of randomized control trials
dc.typeOther

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