Department of Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
Faculty of Medicine, University of Thessaly, Mezourlo, 41110, Larissa, Greece.
Int J Colorectal Dis. 2021 Nov;36(11):2337-2346. doi: 10.1007/s00384-021-03976-w. Epub 2021 Jun 16.
This study was designed to summarize the current evidence regarding the role of percutaneous tibial nerve stimulation (PTNS) in the treatment of chronic anal fissure (CAF).
The present systematic review of the literature was conducted on the basis of the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The primary endpoint of our study was the CAF recurrence rate. Quality assessment was based on the RoB 2 tool and the Case Series Quality Checklist.
Overall, 5 studies and 102 patients were included. A considerably heterogeneity in the neuromodulation technique and setting was identified. The pooled recurrence rate was estimated at the level of 19% (16/84). Post-interventional pain and Wexner scores were considerably reduced. The 2-month healing rate was 72% (18/25), whereas 73.6% of patients were symptom-free at 6 months.
PTNS is an effective alternative for the non-operative management of CAF. Due to several limitations further larger and higher quality studies are required.
本研究旨在总结经皮胫神经刺激（PTNS）在慢性肛裂（CAF）治疗中的作用的现有证据。
本系统综述文献的研究是基于 PRISMA 指南和 Cochrane 干预系统评价手册进行的。我们研究的主要终点是 CAF 的复发率。质量评估基于 RoB 2 工具和病例系列质量检查表。
总共纳入了 5 项研究和 102 名患者。在神经调节技术和环境方面存在相当大的异质性。估计总的复发率为 19%（84 例中有 16 例）。术后疼痛和 Wexner 评分明显降低。2 个月的愈合率为 72%（25 例中有 18 例），而 6 个月时 73.6%的患者无症状。
PTNS 是 CAF 非手术治疗的有效替代方法。由于存在一些局限性，需要进一步进行更大规模和更高质量的研究。
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