dc.contributor.author |
Lin, JX |
en |
dc.contributor.author |
Krishna, Sanjeev |
en |
dc.contributor.author |
Su'a, Bruce |
en |
dc.contributor.author |
Hill, Andrew |
en |
dc.coverage.spatial |
Sydney, Australia |
en |
dc.date.accessioned |
2017-12-10T23:42:40Z |
en |
dc.date.issued |
2016-09 |
en |
dc.identifier.citation |
2015 Annual November Academic Meeting of the Royal Australasian College of Surgeons Surgical Research Society, Sydney, Australia, 12 Nov 2015 - 13 Nov 2015. Diseases of the Colon and Rectum. Springer Verlag. 56: 886-894. Sep 2016 |
en |
dc.identifier.issn |
0012-3706 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/36712 |
en |
dc.description.abstract |
BACKGROUND: Chronic anal fissures are associated with significant morbidity and reduced quality of life. Studies have investigated the efficacy of botulinum toxin with variable results; thus, there is currently no consensus on botulinum toxin dose or injection sites. OBJECTIVE: This study aimed to systematically analyze trials studying the efficacy of botulinum toxin for treatment of chronic anal fissure to identify an optimum dosage and injection regimen. DATA SOURCES: A comprehensive review of the literature was conducted according to PRISMA guidelines. PubMed/Medline, Embase, Scopus, and the Cochrane Library were searched from inception to June 2015. STUDY SELECTION: All clinical trials that investigated the efficacy of botulinum toxin for chronic anal fissure were selected according to specific criteria. INTERVENSIONS: The interventions used were various doses of botulinum toxin. OUTCOME MEASURES: Clinical outcomes, dosage, and injection site data were evaluated with weighted pooled results for each dosage and 95% confidence intervals. RESULTS: There were 1158 patients, with 661 in botulinum toxin treatment arms, from 18 clinical trials included in this review. The outcomes of interest were 3-month healing, incontinence, and recurrence rates. Meta-regression analysis demonstrated a small decrease in healing rate (0.34%; 95% CI, 0–0.68; p = 0.048) with each increase in dosage, a small increase in incontinence rate (1.02 times; 95% CI, 1.0002–1.049; p = 0.048) with each increase in dosage and a small increase in recurrence rate (1.037 times; 95% CI, 1.018–1.057; p = 0.0002) with each increase in dosage. The optimum injection site could not be determined. LIMITATIONS: This study was limited by weaknesses in the underlying evidence, such as variable quality, short follow-up, and a limited range of doses represented. CONCLUSIONS: Fissure healing with lower doses of botulinum toxin is as effective as with high doses. Lower doses also reduce the risk of incontinence and recurrence in the long term. |
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dc.publisher |
Springer Verlag |
en |
dc.relation.ispartof |
2015 Annual November Academic Meeting of the Royal Australasian College of Surgeons Surgical Research Society |
en |
dc.relation.ispartofseries |
Diseases of the Colon and Rectum |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
Optimal dosing of treatment of chronic anal fissure: A systematic review and meta-analysis |
en |
dc.type |
Conference Item |
en |
dc.identifier.doi |
10.1097/DCR.0000000000000612 |
en |
pubs.issue |
9 |
en |
pubs.begin-page |
886 |
en |
pubs.volume |
56 |
en |
dc.rights.holder |
Copyright: Springer Verlag |
en |
dc.identifier.pmid |
27505118 |
en |
pubs.end-page |
894 |
en |
pubs.finish-date |
2015-11-13 |
en |
pubs.start-date |
2015-11-12 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Conference Paper |
en |
pubs.elements-id |
514919 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
South Auckland clinical school |
en |
dc.identifier.eissn |
1530-0358 |
en |
pubs.record-created-at-source-date |
2015-12-22 |
en |
pubs.dimensions-id |
27505118 |
en |