EBM

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER


[Advanced]
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Add article to my folders
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Solomon, M.
Right arrow Articles by Smith, S.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Solomon, M.
Right arrow Articles by Smith, S.
Evidence-Based Medicine 2004; 9:112
© 2004 BMJ Publishing Group Ltd.

Therapeutics

Review: medical therapies are less effective than surgery for anal fissure

Nelson R. Non surgical therapy for anal fissure. Cochrane Database Syst Rev 2003;(4):CD003431.

Q In patients with anal fissure, what is the efficacy and associated morbidity of various medical therapies compared with surgery, other medical therapies, or placebo?

Clinical impact ratings GP/FP/Primary care ******{star} Surgery **{star}{star}{star}{star}{star}

Key Words: fissure in ano

The first 150 words of the full text of this article appear below.

METHODS
Data sources: PubMed (1966 to May 2003), Cochrane Library (May 2003, issue 2), Cochrane Colorectal Cancer Group specialised trials register (May 2003), proceedings of relevant meetings (past 3 y), reference lists of all included reports, and selected authors of published reports.

Study selection and assessment: randomised trials in any language that compared non-surgical therapy with surgery, an alternate medical therapy, or placebo in adults or children with chronic or acute anal fissure. Exclusion criteria: studies of atypical fissures associated with inflammatory bowel disease, cancer, or anal infection. Data were extracted on method of randomisation, blinding, intention to treat, and dropouts.

Outcomes: non-healing (persistence) of fissure (synonymous with persistence of anal pain) and post-treatment minor incontinence (synonymous with incontinence to flatus or anal seepage). In the main results and table of this abstract, however, the results are presented in terms of healing.

MAIN RESULTS
32 randomised controlled trials (n = 2446) met the . . . [Full text of this article]

Michael Solomon, MB, MSc, FRACS, Stephen Smith, MBBS, FRACS

University of Sydney
Sydney, New South Wales, Australia






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
Terms and conditions relating to subscriptions purchased online  ¦  Website terms and conditions  ¦  Privacy policy
Copyright © 2004 by the BMJ Publishing Group Ltd.