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| 1 | Botulinum toxin injections after surgery for Hirschsprung disease:Systematic review and meta-analysis显示文摘BACKGROUND A large proportion of patients with Hirschsprung disease experience persistent obstructive symptoms after corrective surgery.Persistent obstructive symptoms may result in faecal stasis that can develop into Hirschsprung-associated enterocolitis,a potential life-threatening condition.Important treatment to improve faecal passage is internal anal sphincter relaxation using botulinum toxin injections.AIM To give an overview of all empirical evidence on the effectiveness of botulinum toxin injections in patients with Hirschsprung disease.METHODS A systematic review and meta-analysis was done by searching PubMed,EMBASE and the Cochrane Library,using entry terms related to:(1)Hirschsprung disease;and(2)Botulinum toxin injections.14 studies representing 278 patients met eligibility criteria.Data that were extracted were proportion of patients with improvement of obstructive symptoms or less enterocolitis after injection,proportion of patients with adverse effects and data on type botulinum toxin,mean dose,average age at first injection and patients with associated syndromes.Random-effects meta-analysis was used to aggregate effects and random-effects meta-regression was used to test for possible confounding factors.RESULTS Botulinum toxin injections are effective in treating obstructive symptoms in on average 66%of patients[event rate(ER)=0.66,P=0.004,I2=49.5,n=278 patients].Type of botulinum toxin,average dose,average age at first injections and proportion of patients with associated syndromes were not predictive for this effect.Mean 7 duration of improvement after one botulinum toxin injections was 6.4 mo and patients needed on average 2.6 procedures.There was a significant higher response rate within one month after botulinum toxin injections compared to more than one month after Botulinum toxin injections(ER=0.79,vs ER=0.46,Q=19.37,P<0.001).Botulinum toxin injections were not effective in treating enterocolitis(ER 0.58,P=0.65,I2=71.0,n=52 patients).There were adverse effects in on average 17%of patients(ER=0.17,P<0.001,I2=52.1,n=187 patients),varying from temporary incontinence to mild anal pain.CONCLUSION Findings from this systematic review and meta-analysis indicate that botulinum toxin injections are effective in treating obstructive symptoms and that adverse effects were present,but mild and temporary. | Danielle Roorda Zarah AM Abeln Jaap Oosterlaan Lodewijk WE van Heurn Joep PM Derikx | 2019 | World Journal of Gastroenterology2019，25，25： | 4 |
| 2 | Rapidappraisalforagroforestryresearchandextension-TheShurugwiexperience显示文摘 | AbelN PrinsleyR | 1991 | Forest-EcologyandManagement1991，45，： | 1 |
| 3 | The influence of ex- ercise on prefi'ontal cortex aetivity and cognitive performance during a simulated space flight to Mars (Mars-500) 显示文摘 | Schneider S Abeln V Popova J | 2013 | Be- havioural Brain Research2013，236，1： | 1 |
| 4 | Laser Structuring- Improvement of Tribological Properties of Surfaces 显示文摘 | Abeln T | 2003 | VDI Berichte2003，1810，： | 1 |
| 5 | Hydrothermal gasification of biomass and organic wastes 显示文摘 | SCHMIEDER H ABELN J BOUKIS N | 2000 | J Supereritieal Fluids2000，17，2： | 1 |
| 6 | Hydrothermal gasification of biomass and organic wastes显示文摘 | Sehmieder H Abeln J Boukis N | 2000 | Supercritical Fluids2000，17，2： | 1 |
| 7 | Hydrothermal gasification of biomass and organic wastes显示文摘 | H Schmieder J Abeln N Boukis | | 0，，02： | 1 |
| 8 | Newly isolated Bacillus clausii GMBAE 42:analkaline protease producer capable to grow under highly alkaline conditions显示文摘 | A A Demizci D Kazan E C A Abeln | 2004 | Journal ofApplied Microbiology2004，96，： | 1 |
| 9 | Evaluation of the skin sensitizing potential of biodegradable magnesium al oys显示文摘 | Witte F Abeln I Switzer E | | 0，，04： | 1 |
| 10 | Hydrothermal gasification of biomass and organic wastes 显示文摘 | Schmieder H Abeln J Boukis N | 2000 | The Journal of Supercritical Fluids2000，17，2： | 1 |
| 11 | Supercritical water oxidation:state of art显示文摘 | Schmieder H Abeln J 1999 | 1999 | Chemical Engineering and Technology1999，22，11： | 1 |
| 12 | Hydrotherrnal gasification of biomass and organic wastes显示文摘 | SCHMIEDER H ABELN J BOUKIS N | 2000 | J of Supercritieal Fluids2000，17，2： | 1 |
| 13 | Supercritical water oxidation (SCWO) using a transpiring wall reaetor:CFD simulations and ex- perimental results of ethanol oxidation 显示文摘 | Abeln J Kluth M Btltteher M | 2004 | Environmental Engi- neering Science2004，21，1： | 1 |
| 14 | Supercrtical Water Oxidation: State of the Art显示文摘 | Schmieder H Abeln J | | 0，，： | 1 |
| 15 | Results and rough cost estimation for SCWO of painting effluents using a transpiring wall and a pipe reactor 显示文摘 | Abeln J Kluth M Pagel M | 2007 | Journal of Advanced Oxidation Teehnologies2007，10，1： | 1 |
| 16 | Hydrothermal Gasification of Biomass and organic wastes显示文摘 | Schmieder H Abeln J Boukis N | 2000 | Journal of Supercritical Fluids2000，17，： | 1 |
| 17 | Super- critical water oxidation (SCWO) using a transpiring wall reactor: CFD simulations and experimental re- suits of ethanol oxidation显示文摘 | ABELN J KLUTH M BOTTEHER M | 2004 | Environmental Engi- neering Science2004，21，1： | 1 |
| 18 | How old is your fold? 显示文摘 | Winstanley H F Abeln S Deane C M | 2005 | Bioinformatics2005，21，： | 1 |
| 19 | Supercritical water oxidation:State of the art显示文摘 | Schmieder H Abeln J | 1999 | Chemical Engineering & Technology1999，22，11： | 1 |
| 20 | Rapidappraisalforagroforestryresearchandextension-TheShurugwiexperience显示文摘 | AbelN PrinsleyR | 1991 | ForestEcologyandManagement1991，45，： | 1 |
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