P4580 - Efficacy of Laser Therapy in the Management of Chronic Anal Fissure: A Systematic Review and Meta-Analysis

Sheza Malik, MD¹, Priyadarshini Loganathan, MD², Marina Takawy, MD³, Dushyant S. Dahiya, MD⁴, Douglas G. Adler, MD, FACG⁵
1Emory University, Atlanta, GA; 2University of Texas Health San Antonio, San Antonio, TX; 3Rochester Regional Health, Unity Hospital, Rochester, NY; 4University of Kansas School of Medicine, Kansas City, KS; 5Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO

Introduction:

Chronic anal fissure (CAF) is a common and painful condition, often resistant to conservative treatments. Traditional surgical interventions like lateral internal sphincterotomy (LIS) are effective but associated with risks such as fecal incontinence. Laser therapy has emerged as a minimally invasive alternative.

Methods:

A systematic review of studies evaluating laser therapy for CAF was conducted, focusing on outcomes such as pain reduction at 1 and 3 months, adverse events, bleeding, and persistent pain. Meta-analyses were performed using a random-effects model.

Results: 5 studies comprising 303 patients were included., Laser therapy significantly reduced pain with a pooled pain score of 4.4 (95% CI: 1.10-7.29, p=0.009, I2= 99%) at 1 month and 3.19 (95% CI: 1.93-4.45, p=0.00, I2= 98%) at 3 months, respectively. Adverse events occurred in  8% of patients (95% CI: 2-10%) of patients.

Discussion:

Laser therapy is a promising, minimally invasive treatment for CAF, offering significant pain relief and a low risk of complications. Further studies are needed to confirm these findings and establish standardized treatment protocols.


Figure: Pain Score after Laser Therapy at 1 and 3 months


Figure: Total Adverse Events Secondary to Laser Therapy

Disclosures:
Sheza Malik indicated no relevant financial relationships.
Priyadarshini Loganathan indicated no relevant financial relationships.
Marina Takawy indicated no relevant financial relationships.
Dushyant Dahiya indicated no relevant financial relationships.
Douglas Adler: Boston Scientific – Consultant.

Sheza Malik, MD¹, Priyadarshini Loganathan, MD², Marina Takawy, MD³, Dushyant S. Dahiya, MD⁴, Douglas G. Adler, MD, FACG⁵. P4580 - Efficacy of Laser Therapy in the Management of Chronic Anal Fissure: A Systematic Review and Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.