Carbon Dioxide Laser Anal Stenotomy for Acquired Low Anal Stenosis: Early Clinical Outcomes and Feasibility Study
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Anal stenosis is a pathological narrowing of the anal canal, most commonly following hemorrhoidectomy. Moderate and severe cases usually require surgery, as conservative measures are often ineffective. Conventional procedures, such as flap anoplasty, are effective but associated with relevant morbidity. The role of carbon dioxide (CO2) laser surgery remains insufficiently explored. To evaluate the feasibility and early clinical and functional outcomes of CO2 laser anal stenotomy in patients with acquired anal stenosis. Adults (≥ 18 years) undergoing CO2 laser anal stenotomy for acquired anal stenosis between January 2021 and December 2024 were included. Patients with congenital stenosis, infection, neoplasia, trauma, or requiring flap anoplasty were excluded. Stenosis location and severity were clinically assessed. Three radial CO2 laser incisions (3, 7, and 11 o'clock) were performed. Follow-up at 10, 30, 60, and 120 days assessed healing, pain, symptoms, continence, and reintervention. In total, 16 patients were included (mean age: 55.3 ± 9.2 years; 62.5% of female subjects). Difficult evacuation was present in all patients, and 50% had severe stenosis. Previous anorectal surgery was reported in 93.8%, predominantly hemorrhoidectomy. Complete wound epithelialization was achieved in all patients by postoperative day 30. Improvement in evacuation was reported by 81.3% on day 10 and maintained in 87.5% on day 60. Also, two patients experienced transient fecal incontinence, and no reintervention was required. Anal stenotomy with CO2 laser appears to be a safe, minimally invasive option for moderate and severe low anal stenosis, providing rapid healing, sustained symptom improvement, and low postoperative morbidity. Larger prospective studies are warranted.
Source: Journal of Coloproctology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225409971