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Scanner-Assisted CO2 Laser Fissurectomy: A Pilot Study.
Giani Iacopo1, Cioppa Tommaso1, Linari Chiara1
1SOSD Proctologia, USL Toscana Centro, Florence, Italy.
Frontiers in Surgery
|January 14, 2022
Summary
Scanner-assisted CO2 laser fissurectomy offers a promising alternative for chronic anal fissure treatment, achieving high healing rates and significant pain reduction. This advanced technique minimizes thermal damage, improving patient outcomes and potentially reducing incontinence risks associated with traditional surgery.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Laser Technology in Medicine
Background:
- Chronic anal fissure surgery presents challenges, with traditional methods like internal sphincterotomy risking fecal incontinence.
- Effective pain management and rapid, functional healing are key objectives in treating anal fissures.
Purpose of the Study:
- To evaluate the effectiveness of scanner-assisted CO2 laser fissurectomy for chronic anal fissures.
- To assess pain control, wound healing, and functional outcomes post-procedure.
Main Methods:
- A prospective study involving consecutive patients with chronic anal fissures undergoing scanner-assisted CO2 laser fissurectomy.
- Data collection included pain intensity, healing status, and functional outcomes at 24 hours, 1 week, and 1 month post-surgery.
Main Results:
- 89.7% success rate with mean pain intensity ≤3 at 1-month follow-up.
- Statistically significant reduction in pain, itching, bleeding, burning, and maximum pain.
- 75.9% complete reepithelization and 14% partial reepithelization at 1 month.
Conclusions:
- Scanner-assisted CO2 laser fissurectomy demonstrates excellent pain control and rapid wound healing.
- This technique offers a precise ablation, vaporization, and debridement with minimal thermal damage, suggesting a safer alternative to internal sphincterotomy for anal fissures.
