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

https://doi.org/10.1136/ebm.9.4.112

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    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 ★★★★★★☆ Surgery ★★☆☆☆☆☆

    METHODS

    Embedded ImageData 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.

    Embedded ImageStudy 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 …

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