General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura University, 60 El-Gomhoria Street, Mansoura, 35516, Dakahlia, Egypt.
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Lasers Med Sci. 2022 Sep;37(7):2775-2789. doi: 10.1007/s10103-022-03577-1. Epub 2022 May 23.
Surgery for benign anal conditions is a common practice and is usually followed by a good outcome. The present review aimed to summarize the emergence and evolution of different laser techniques used for the treatment of benign anal conditions and report their current outcome. PubMed and Scopus were searched for studies that assessed the use of laser in benign anal conditions. Anal conditions reviewed were hemorrhoids, anal fistula, anal warts, anal stenosis, and anal fissure. The full text of the studies retrieved was summarized in a narrative and tabular form. Laser techniques used for the treatment of hemorrhoidal disease were laser open hemorrhoidectomy, laser hemorrhoidoplasty, and Doppler-guided hemorrhoidal laser dearterialization. Resolution of hemorrhoidal symptoms was reported in 72-100% of patients after laser treatment. YAG laser, fistula laser closure, and photodynamic therapy have been used for the treatment of anal fistula with success rates ranging from 20 to 92.6%. Anal warts can be treated with photodynamic therapy with or without YAG or CO laser with a success rate up to 88%. A few studies reported the use of laser in the treatment of chronic anal fissure and anal stenosis. The use of laser in the treatment of benign anal conditions is associated with promising outcomes. Laser was most assessed in hemorrhoidal disease and anal fistula and showed more consistent success rates with hemorrhoidal disease than with anal fistula. Preliminary reports assessed the outcome of laser treatment in other conditions as anal fissure and warts with acceptable outcomes.
治疗良性肛门疾病的手术是一种常见的做法,通常结果良好。本综述旨在总结用于治疗良性肛门疾病的不同激光技术的出现和发展,并报告其当前的结果。在 PubMed 和 Scopus 上搜索评估激光在良性肛门疾病中的应用的研究。回顾的肛门疾病包括痔疮、肛瘘、肛门疣、肛门狭窄和肛裂。检索到的研究的全文以叙述性和表格形式进行总结。用于治疗痔病的激光技术包括激光开放性痔切除术、激光痔成形术和多普勒引导痔激光去动脉化。激光治疗后,痔疮症状的缓解率为 72%-100%。YAG 激光、瘘管激光闭合术和光动力疗法已成功用于治疗肛瘘,成功率为 20%-92.6%。肛门疣可以用光动力疗法联合或不联合 YAG 或 CO 激光治疗,成功率高达 88%。少数研究报告了激光在慢性肛裂和肛门狭窄治疗中的应用。激光治疗良性肛门疾病的效果良好。激光在痔病和肛瘘治疗中的应用最为广泛,其痔病治疗的成功率比肛瘘治疗的成功率更为一致。初步报告评估了激光治疗其他疾病(如肛裂和疣)的结果,结果可接受。