Outcome of laser therapy in patients with anal fissure

Fateh, Shahin; Shafighi, S Darvish; Norouzi, Afsaneh; Kalantari, Masoumeh

doi:10.7707/hmj.423

Cited by 7 publications

(3 citation statements)

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“…As a result, it is regarded as convenient and beneficial for the treatment of anal fissures. 21 Using CO2 laser for chronic anal fissures surgeries has the additional advantage of minimal blood loss and thereby better vision of the site of operation to the naked eye. A laser sphincterotomy and fissurectomy have proven to be very successful therapeutic options since the development of the CO2 laser.…”

Section: Laser Surgeriesmentioning

confidence: 99%

“…Numerous studies have shown that laser exposure can start the regeneration of various tissues because it encourages the development of fibroblasts, increased epidermal growth, collagen formation, vascular structure growth, and total healing. 4,5,21 In a specific study from 2017 conducted on 200 patients suffering from chronic anal fissures, minimally invasive laser electrocoagulation with the help of nitroglycerine or nifedipine was evaluated using anesthesia. The internal sphincter and its margins stay completely unaffected by the electrocoagulation of the fissure.…”

Section: Laser Surgeriesmentioning

confidence: 99%

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A review of recent advances in the surgical management of anal fissures

Nayar¹,

Joshi²,

Jamal

et al. 2023

Int Surg J

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An anal fissure is a rupture or lesion in the anal canal's lining below the mucocutaneous junction or dentate line. It is a painful condition that can last for up to two hours during and after defecation. The present literature review is aimed at outlining the clinical signs and symptoms, etiopathogenesis, clinical evaluation, and surgical management of anal fissures with a brief discussion on laser-assisted surgeries. This literature review has been compiled to revisit the different treatment modalities of anal fissures based on the recent updates in the literature. PubMed and ScienceDirect databases were used for the literature search of this review. Based on the literature review surgical interventions are necessary when the conventional pharmacological treatment fails to cure the disease. There are varying outcomes based on the type of surgery with respect to healing rates, recurrence, and incontinence. However, the outcomes of surgery may vary from patient to patient. Various studies have shown that lateral internal sphincterotomy is currently considered the most effective surgical treatment for anal fissures. Surgeons may choose to use either the closed or open method for this procedure. Using lasers for sphincterotomy can help to minimize bleeding and postoperative pain. Despite numerous clinical practice guidelines and systematic reviews, there is still debate over the ideal anal fissure treatment. Surgical treatments discussed in this review have varying advantages and the surgeon is the right person to decide which procedure is suitable for the patient.

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Section: Laser Surgeriesmentioning

confidence: 99%

Section: Laser Surgeriesmentioning

confidence: 99%

A review of recent advances in the surgical management of anal fissures

Nayar¹,

Joshi²,

Jamal

et al. 2023

Int Surg J

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“…Laser therapy for perianal lesions is a non-contact procedure that often causes the patient to have reduced bleeding, pain, and discomfort. Therefore, it is regarded as a good alternative for the treatment of perianal and rectal tumors, anal fistula, hemorrhoids, and anal fissure (7) . Numerous researches on the use of laser therapy for the treatment of tumors, anal fistulas, and hemorrhoids have been conducted in the last ten years.…”

Section: Introductionmentioning

confidence: 99%

Comparing Outcomes of Lateral Internal Sphincterotomy, Botulinum Toxin Injection and Laser Therapy in the Management of Chronic Anal Fissure

Maurice¹,

Amin²,

Habeeb³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Chronic anal fissure (CAF), which affects both sexes equally, typically develops in early adulthood. For the therapy of CAF, laser sphincterolysis and botulinum toxin (BTX) have been used. Objective: The aim of the present study was to evaluate the effectiveness of BTX injection and laser in the treatment of CAF. Patients and methods: Our clinical trial included 150 patients with CAF and assigned into one of the 3 modalities of treatment: lateral internal sphincterotomy (50 patients, BTX (50 patients) and laser sphincterolysis (50 patients). In BTX group, 20 U was diluted in 1ml isotonic saline and half of this dose was injected on each side of the fissure in all cases. Regarding laser sphincterolysis, all procedures were carried out using the Lasotronix Smart M 1470 nm diode laser (Poland); for Anal fissure 70-100 W energy given. Patients were followed up after 1 week then every 2 weeks for 8 weeks after intervention. Results: All cases in all groups stayed for one day at hospital. Healing period was significantly shorter among Botox group then laser group and significantly longer among open group. In BTX group, 7.5% of the patients were reinjected with the same dose of botulinum toxin and had healed fissure 2 months after reinjection. Incontinence was significantly associated with open group and was lower in laser and Botox groups with no significant difference between them. Conclusion: BTX injection is more suitable first-line treatment of choice for chronic idiopathic anal fissure, which is not associated with other anal conditions. It is a simple procedure, easy to learn and can be done in outpatient clinic without need for sedation or local anesthesia. Regarding laser, it has less operation time, discharge may be given within a few hours, within a day patients can go back to normal routine work, with greater surgical precision and fastest recovery, fewer blood loss during surgery and no or minimal post-operative pain.

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