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Long term continence disturbance after lateral internal sphincterotomy for chronic anal fissure : A systematic review and meta-analysis.
MedLine Citation:
PMID:  23320551     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: A systematic review was carried out to analyze continence at two years or more after lateral internal sphincterotomy (LIS) for chronic anal fissure (CAF). METHOD: Pubmed, Medline, Scopus, Embase SCI database, Cochrane, Google Scholar were used to search the literature from 1969-2012 for studies reporting a follow up of more than two years after LIS for CAF. The primary outcome parameter analyzed was continence. The secondary outcome parameters included success rate, recurrence, incidence of postoperative abscess & fistula formation and the patient satisfaction. RESULTS: Of 324 studies screened, 22 (n=4512) were included. The mean follow-up period ranged from 24-124 months. The overall continence disturbance rate was 14% (95% CI-0.09-0.2). Weighted analysis showed flatus incontinence in 9% (95% CI-0.04-0.16), soilage/seepage in 6% (95% CI-0.03-0.1), accidental defaecation in 0.91% (95% CI-0.003-0.02), incontinence to liquid stool in 0.67% (95% CI-0.001-0.02) and incontinence to solid stool in 0.83% (95% CI-0.003-0.02) of patients. CONCLUSION: The long term risk of continence disturbance after lateral internal sphincterotomy is significant. Randomized controlled trials with a long follow-up are needed to substantiate these findings and to redefine the role in the treatment of chronic anal fissure. © 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Authors:
Pankaj Garg; Mahak Garg; Geetha R Menon
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-15
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Fortis Super Specialty Hospital, Mohali, Punjab, India; MM Institute of Medical Sciences & Research, Mullana, Haryana, India.
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