How to do a Fistula tract Laser Closure (<scp>FiLaC</scp>) for trans‐sphincteric fistula‐in‐ano

Suhardja, Thomas Surya; Lim, James T.; Duieb, Zeev; Nguyen, Trung Thành; Teoh, William; Chouhan, Hanumant

doi:10.1111/ans.16778

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…FILAC technique does not impact the sphincter function degradation as a result of the laser energy's denaturation effect, which is limited to the fistula lumen (11). Compared to video assisted techniques, FILAC has a shorter learning curve, doesn't impair continence, has a controlled hyperthermic effect on the tissues, and shortens the length of hospital stay following surgery when compared to endorectal advancement flap or LIFT (12).…”

Section: Discussion Discussionmentioning

confidence: 99%

Focus on the Internal Orifice Closure and Mucosal Advancement Flap in FILAC Technique

Cimpean,

Baillon,

Mehdi

2024

SGO

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A cryptoglandular abscess, which can result in a perianal abscess and fistula, is caused by an anal gland infection. An anal fistula occurs in 40-66% of perianal abscesses. The general indications for this method range from high trans sphincteric fistulas to "short" (3 cm) trans sphincteric fistulas to inter sphincteric fistulas. We present the case of a 36-year-old patient who has a trans sphincteric anal fistula. The patient had an anal abscess that was drained in emergency. A seton was placed when an internal opening in the anal canal was detected. Local irrigations with a good evolution were used for local care. In the absence of infection and inflammation, we decided to proceed with the FILAC surgery with internal orifice closure and mucosal advancement flap, the second phase in the anal fistula treatment. Simple sutures may be less successful if the internal opening is surrounded by fibrous, poorly vascularized scar tissue. We believe that proper sealing of the fistula trajectory from faecal spillage is critical for complete healing after Laser treatment and can reduce the morbidity and recurrence. One of the most important aspects in fistula therapy is the correct closure of the internal opening of the fistula trajectory with adequate measures to avoid incontinence.

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Section: Discussion Discussionmentioning

confidence: 99%

Focus on the Internal Orifice Closure and Mucosal Advancement Flap in FILAC Technique

Cimpean,

Baillon,

Mehdi

2024

SGO

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“…They determined that FiLaC is a viable option for complex fistulas with benefits such as not impacting sphincter function, having a short learning curve, reducing post-operative hospital stay, and having success rates comparable to other surgical procedures for the management of complex fistulas. 16 They proposed that the use of laser ablation to preserve the sphincter is a viable initial treatment option for complex fistulas, but further evaluation of its cost-effectiveness is necessary, particularly in cases where multiple surgeries may be required due to higher recurrence rates. 16 In our study, 80 patients with transsphincteric fistulas who had undergone preliminary seton insertion were randomly divided into two groups.…”

Section: Discussionmentioning

confidence: 99%

“…16 They proposed that the use of laser ablation to preserve the sphincter is a viable initial treatment option for complex fistulas, but further evaluation of its cost-effectiveness is necessary, particularly in cases where multiple surgeries may be required due to higher recurrence rates. 16 In our study, 80 patients with transsphincteric fistulas who had undergone preliminary seton insertion were randomly divided into two groups. The first group underwent fistulectomy with subsequent sphincter repair, while the second group underwent laser ablation of the fistula tract.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Laser Ablation and Fistulectomy with Sphincteroplasty for the Management of Transsphincteric Fistulas Following Preliminary Seton Insertion

El-Wahab

Abd-erRazik

Elsaid

2023

Ain Shams Journal of Surgery

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Background: Cryptoglandular perianal fistulas are a frequent problem, and the traditional surgical procedure carries a risk of incontinence and recurrence. The ultimate goal of fistula management is to resolve and prevent sepsis, eradicate the fistula, prevent recurrence, and ensure continence. Laser Ablation of Fistula Tract (LAFT) offers a viable alternative sphincter-saving modality. Patient and methods:In this study, we performed a randomized controlled trial to evaluate the safety and efficacy of laser ablation as a treatment for transsphincteric fistulas. This study was conducted at Ain Shams University hospitals from June 2019 to June 2022 and included eighty patients with cryptoglandular transsphincteric fistulas who had undergone previous drainage and seton, they were divided into two groups. The first group (Group A) underwent fistulectomy with subsequent sphincteroplasty while the second group (Group B) underwent laser ablation of the fistula tract. Follow-up was scheduled in the outpatient clinic at 1 and 2 weeks and 1, 3, and 6 months postoperatively. The Cleveland Clinic Florida Fecal Incontinence CCF-FI score and the visual analog scale (VAS) score were recorded at each visit. Results:The results of the study showed that the laser ablation of the fistula track technique is a safe and effective sphincter-saving modality for transsphincteric fistula management with acceptable healing rates. The technique also carries the advantages of a short learning curve, reduced hospital stay, and minimal risk of incontinence. Conclusion:Our study found that laser ablation is a safe and effective treatment option for transsphincteric fistulas. Preliminary seton insertion may have a positive impact on postoperative outcome. However, there is a need for further research to evaluate the long-term outcomes..

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How to do a Fistula tract Laser Closure (FiLaC) for trans‐sphincteric fistula‐in‐ano

Cited by 2 publications

References 6 publications

Focus on the Internal Orifice Closure and Mucosal Advancement Flap in FILAC Technique

Focus on the Internal Orifice Closure and Mucosal Advancement Flap in FILAC Technique

Comparison of Laser Ablation and Fistulectomy with Sphincteroplasty for the Management of Transsphincteric Fistulas Following Preliminary Seton Insertion

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