The authors stated that the main drawbacks of this meta-analysis included the short-term follow-up (mean of 25.7 months), especially in the ATOMS-arm, and in the very high heterogeneity observed between studies; probably reflecting a variable severity of sphincteric damage included and the absence of RCTs. Furthermore, the criteria to report complications appeared variable between the studies analyzed. The drawbacks highlighted were in consonance with the publication bias identified according to Egger’s linear regression. It should also be noted that the ATOMS studies had shorter follow-up than the ProACT studies (20.8 months versus 30.6 months).