FILAC – Fistula – Tract Laser Closure: a sphincter-preserving procedure for the treatment of complex anal fistulas

Carvalho, Alexandre Lopes de; Filho, Eduardo Fonseca Alves; Alcantara, Rogerio Souza Medrado de; Barreto, Marcelo da Silva

doi:10.1016/j.jcol.2017.03.001

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…In studies done from 2009 many studies have shown that there was no FI in LIFT. 1,3,9,15,[18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] In our study too none of the patients of LIFT developed FI. Though few patients of CF developed FI the results comparing LIFT and CF were not significant in our study.…”

Section: Discussionmentioning

confidence: 65%

A comparative study of Ligation of Intesphincteric Fistula Tract versus conventional fistulectomy in management of low fistula in ano: a randomized control trial

Goudar¹,

Dakhani²

2020

Int Surg J

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Background: Fistula in ano (FIA) is a chronic complex condition of ano-rectal sepsis characterized by cylical-pain and intermittent chronic purulent discharge. The management of fistula is challenging. In spite of all the advances in the management of FIA, no single method is univresally applicable to all types of FIA due to incontinence and recurrences associated with the individual procedures.Methods: Aims of this study were to compare the outcomes between ligation of intersphincteric fistula tract (LIFT) and conventional fistulectomy (CF) with 60 patients randomized into 2 groups, 30 in each group.Results: Mean age in LIFT was 44.17 years and in CF was 41.1 years. Successful primary healing was observed in 86.7% of LIFT and 100% of CF. Mean pain scores were lower in LIFT compared to CF when checked on Postoperative days 1, 3 and 7 significantly. Anal incontinence was seen in 10% of CF and none in LIFT and recurrence was seen at same site in LIFT in 6.66% of LIFT and none in CF both being not statistically significant.Conclusions: LIFT is a promising and sphincter saving technique which is simple and easy to learn with faster healing rates and better patient contentment but with risk of failure and recurrence. Modifications of LIFT have to be probed for minimizing the failures.

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Section: Discussionmentioning

confidence: 65%

A comparative study of Ligation of Intesphincteric Fistula Tract versus conventional fistulectomy in management of low fistula in ano: a randomized control trial

Goudar¹,

Dakhani²

2020

Int Surg J

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“…Many publications 1,3,4,7,11,16,19,20 have appeared in recent years on the use of low-level laser in the treatment of anal fistula, but all in humans and with a specific product that requires a probe for internal laser application. Despite the good results presented, as also seen in other techniques 9,15 , it is necessary to consider the high cost, the need of hospitalization and the need to close the internal orifice according to the description of the technique.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Low-Level Laser Therapy on Fistula-in-Ano Treatment

Santos

Guimarães

Barros

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Treating anal fistulae is still a great challenge due to the possibility of fecal incontinence after surgery and that the use of laser has been gaining space in medicine, including as an inducing method of healing. Aim: To evaluate the efficacy of low-level laser therapy on fistula-in-ano treatment in rats. Methods: Fifteen male Wistar rats weighing approximately 250-300g were used, which were subjected to the anal fistula induction procedure and after 30 days were distributed into two groups: control group (CG, n=5) and laser group (LG, n=10) observed for another 30 days. In the CG no treatment was performed and, in the LG, low-level laser therapy was applied in fistulous tracts daily. The closure of the fistulous tract, the area of the remaining tract, the inflammatory infiltrate and vascular congestion were evaluated. Results: There was no complete closure of the tract in any of the animals. The mean area of the remaining tract was 847.2 µm2 in the CG and 248.5 µm2 in the LG (p=0.001). The mean inflammatory infiltrate score was 2.4 in the CG and 1.3 in the LG (p=0.0285), while in the evaluation of vascular congestion, 1.6 was observed in the CG and 0.6 in the LG (p=0.031). Conclusions: Low-level laser therapy was able to reduce the area of the fistulous tracts as well as decrease the inflammatory process and local vascular congestion.

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“…Since 2011, advances have been made in this technology, such as the development of the FiLaC method by Giamundo [5], and others have assessed the effectiveness of this technique. They found that laser fistulectomy had low complication rates and was successful at curing complex anal fistula tracts, with cure rates ranging from 40 to 88% [3][4][5][6][7][8][9][10][11][12]. Our aim was to add to this growing body of literature by conducting a retrospective case analysis assessing the effectiveness of laser fistulectomy in curing fistula-inano tracts within a cohort of patients at a single academic institution.…”

Section: Introductionmentioning

confidence: 99%

Assessing the effectiveness of laser fistulectomy for anal fistula: a retrospective cohort study

et al. 2020

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Background Laser fistulectomy is a minimally invasive, sphincter-sparing procedure for treatment of anal fistula. In several studies, this method has been shown to be safe and effective, with reported success rates ranging from 40 to 88%. We hypothesized that with longer follow-up, these rates would decrease.Methods A retrospective case analysis assessing the effectiveness of laser fistulectomy in curing fistula-in-ano tracts within a cohort of patients at a single academic institution was conducted. All patients having laser ablation between March 2016 and July 2018 were analyzed. Cure of the fistula was determined by history and postoperative physical exam, and was defined as complete closure of fistula tract with resolution of symptoms. Secondary symptoms of fecal incontinence, infection, and pain were evaluated. ResultsEighteen patients (10 males, mean age 41 ± 13 years) were analyzed. Transphincteric fistula was the most common type (67%, N = 12). The mean number of previous fistula procedures was 1.33 ± 1.64. There was a 22% (N = 4) success rate at an average postoperative follow-up period of 29 ± 8 months (range 18-46 months). Of those who failed, 64% (N = 9) had a subsequent fistula procedure. There were no cases of fecal incontinence, but 3 cases (17%) of postoperative infection were reported and 8 patients (44%) had a subjective increase in pain at first follow-up appointment.Conclusions Our data showed a much higher failure rate of laser fistulectomy compared to those reported in the literature. However, the small sample size, a large amount of heterogeneity in our patient population with a mixture of fistula types present, and various laser techniques applied decreased the power of this study.

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FILAC – Fistula – Tract Laser Closure: a sphincter-preserving procedure for the treatment of complex anal fistulas

Cited by 9 publications

References 6 publications

A comparative study of Ligation of Intesphincteric Fistula Tract versus conventional fistulectomy in management of low fistula in ano: a randomized control trial

A comparative study of Ligation of Intesphincteric Fistula Tract versus conventional fistulectomy in management of low fistula in ano: a randomized control trial

Efficacy of Low-Level Laser Therapy on Fistula-in-Ano Treatment

Assessing the effectiveness of laser fistulectomy for anal fistula: a retrospective cohort study

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