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A systematic review and network meta-analysis comparing treatments for anal fissure.

Jin JZ, Bhat S, Park B, Hardy M-H, UnasaH, Mauiliu-Wallis M et al.

Surgery 2022; 172: 41-52.

Sixty-nine RCTs were included. Botulinum toxin was shown to be similarly effective to other medical treatments for initial care. Surgical lateral sphincterotomy had the highest healing rate and was considered definitive after failed medical treatment.

Comment; Clear evidence-based advice.

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