Anal fissure is a common painful problem, affecting all age groups. Its pathophysiology is based on high sphincter pressures and reduced blood supplying and treatments which means that it generally reduces anal pressures and increases anodermal blood flow. Since each of the
anal fissure's routine
therapies has some limitations such as definite risk of permanent
fecal incontinence and high recurrence rate, we tried to find a more effective and less invasive procedure. In this pilot study which was implemented on 25 male and female patients aged 20-75 years, diagnosed clinically with chronic
anal fissure, the
Carbon Dioxide Laser Fractional was used to treat patients. In order to first remove fibrotic and granulation tissues, the base and the edges of the fissure were
laser beamed. Eight spots were made on the sphincter by the
laser on its continuous mode; somehow, they were passed through the full thickness of sphincter without interrupting its continuance. Afterwards, the area around the fissure
ulcer was irradiated by deep fractional mode of the
laser to stimulate the submucosa to regenerate and rejuvenate. After going through this procedure, patients were followed up within 6 months to 1 year.
Pain,
bleeding, and
constipation were significantly improved. None of the patients had recurrence after a 1-year follow-up, and none of them had
fecal incontinence and/or inability to control the passage of gas too. This study revealed that this new
laser-based surgery is a simple, safe, and effective procedure to treat the
anal fissure that can be performed with
local anesthesia in an outpatient clinic with minimal postoperative morbidity.