TY - JOUR
AU - Khera, G
AB - Sir We applaud the efforts of Brisinda et al. in this RCT comparing botulinum toxin injections with 0·2 per cent nitroglycerin (GTN) ointment for chronic anal fissure. We found the results interesting and they will certainly provide useful data for further trials. The authors reported a significant superior benefit in healing at 2 months after treatment with botulinum toxin compared with GTN ointment. However, it would also be interesting to know the proportion of subjects who had symptomatic improvement at 2 months, as there was no statistical difference at 1 month between treatment groups (P = 0·262). Furthermore, compliance as a cause of failure rates for the GTN group was not assessed and this has confounded the results. The 12 patients in the GTN group who later had botulinum toxin injection were found to have no change in the mean anal tone before and after treatment with GTN. One could speculate that this is a result of poor compliance with GTN treatment. Perhaps the technique of using a gloved finger to apply the GTN ointment, which is a proven method to reduce side effects, could have been introduced1. We also question the authors' use of the Student's t test for comparing the difference in rectal tone pre- and post-treatment. The paired t test is usually preferred when measurements are taken from the same sample before and after intervention. References 1 Minguez M , Herreros B, Benages A. Chronic Anal Fissure . Curr Treatm Options Gastroenterol 2003 ; 6 : 257 – 262 . Google Scholar Crossref Search ADS WorldCat Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
TI - Randomized clinical trial comparing botulinum toxin injections with 0·2 per cent nitroglycerin ointment for chronic anal fissure (Br J Surg 2007; 94: 162–167)
JO - British Journal of Surgery
DO - 10.1002/bjs.5877
DA - 2007-04-19
UR - https://www.deepdyve.com/lp/oxford-university-press/randomized-clinical-trial-comparing-botulinum-toxin-injections-with-0-pUClTRrIrA
SP - 646
EP - 646
VL - 94
IS - 5
DP - DeepDyve
ER -