Abstract

Fistula-in-ano is an abnormal communication between the anal canal or rectum and the perianal skin, which causes a chronic inflammatory response. Fistulectomy is the gold standard in the treatment of anal fistulas. patients treated with a Fistulectomy are at risk of developing postoperative anal sphincter dysfunction. The ‘‘laser therapy of fistula in ano" is another option of  management of fistula in ano.  The study was conducted to assess the efficiency of laser therapy  in Fistulectomy.
A clinical trial study was enrolled patients complaining from anal fistula. The study conducted in Aldiwanyia teaching hospital and in private hospital. Patients of either sex with variable types of fistula were enrolled between June 2017  to December 2020. One hundred patients were assigned into two group according to type of treatment, first group 50 patients were undergone laser therapy and second group 50 patients were surgical treatment for fistula.
 The mean age of sample was 46.3±9.4 and male to female ratio 2.3:1. Fifty three percent of patients presented with intersphincter  type of fistula and 24% transphincter  types as in table two. Many patients show more than one clinical feature, 39% show discharge, 58% presented with pain and 47% with swelling. Success seen in laser procedure were 84% recurrence seen in 12% whereas in surgical procedure 72% cured rate and 22% recurrence of fistula was happened during period of follow up. 
Pain was the common complication post operative in both procedures, 42% in laser and 76% in surgery, 2% show urinary retention in laser therapy of fistula in ano and 16% in surgery , bleeding was presented in surgical treatment than laser procedure    and incontinence only seen in surgical treatment