S487 Efficacy of Laser Therapy in the Management of Chronic Anal Fissure: A Systematic Review and Meta-Analysis

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: Five studies comprising 303 patients were included. Laser therapy significantly reduced pain with a pooled pain score of 4.4 (95% confidence interval [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. Conclusion: 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.