Fistula-tract Laser Closure (FiLaC™): long-term results and new operative strategies

Giamundo, Paolo; Esercizio, L.; Geraci, Maria; Tibaldi, Livio; Valente, Marco

doi:10.1007/s10151-015-1282-9

Cited by 120 publications

(109 citation statements)

References 13 publications

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“…The first cases with CD-related fistulas treated with this technique were described in two patients from an initial series of 33 cases of overall perianal fistulas, by Giamundo et al 99 Later, the same authors described their experience in 45 cases, but no further CD cases were added 100…”

Section: Modern Surgical Techniques For Perianal Fistulas In CDmentioning

confidence: 99%

Modern management of perianal fistulas in Crohn’s disease: future directions

Kotze

Shen

Lightner

et al. 2018

Gut

130

104

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Perianal fistulae in patients with Crohn's disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%. More recently, newer biologics, cell-based therapies as well as novel endoscopic and surgical techniques have been introduced raising new hopes that outcomes can be improved upon. In this review, we describe the modern management and the most recent advances in the management of complex perianal fistulising CD, which will likely impact clinical practice. We will explore optimal use of both older and newer biological agents, as well as new data on cell-based therapies. In addition, new techniques in endoscopic and surgical approaches will be discussed.

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Section: Modern Surgical Techniques For Perianal Fistulas In CDmentioning

confidence: 99%

Modern management of perianal fistulas in Crohn’s disease: future directions

Kotze

Shen

Lightner

et al. 2018

Gut

130

104

View full text Add to dashboard Cite

show abstract

“…In the FiLaC technique the chronically inflamed connective tissue is ''burned'' by the laser energy allowing tissue repair by the macrophages and fibroblasts coming from the surrounding healthy connective tissue [13]. The results obtained by the few authors who have used this new technique are really exciting [2,13,14] but, since the commonest bias in clinical research is to fall in love with our own ideas or personal technique, we do need to test the reproducibility of this new technique on larger series and to ''pass the exam'' of randomized controlled trials comparing the new procedure with other surgical techniques used to treat anal fistulas.…”

mentioning

confidence: 87%

“…A pretty new conservative proposal to treat anal fistula involves the use of energy delivery devices (such as laser) to destroy the chronically inflamed connective tissue of the fistula tract by means of a probe inserted into the fistula tract as is reported in this issue of the journal [2]. Actually, the idea of using laser energy is not completely new as it was suggested in two studies in 1981 [3] and 1995 [4] but with different techniques and energy devices.…”

mentioning

confidence: 99%

“…Giamundo et al [2] draw attention to two critical aspects of the management of this common and often frustrating anal disease. The first concerns the treatment (or not) of the internal opening of the fistula.…”

mentioning

confidence: 99%

“…Nowadays the proponents of the LIFT operation say that just the interruption the fistula tract close to the internal opening is enough to get a 70 % or higher primary healing rate [5], even in complex anorectal fistulas [6]. Similarly, FiLaC consists of blind cauterization of the tract without addressing the internal opening with a long-term success rate of 71 % [2].…”

mentioning

confidence: 99%

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Anal fistula closure with FiLaC: new hope or the same old story?

Altomare

2015

Tech Coloproctol

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Throughout the centuries human beings have suffered from anal fistula.The history of medicine is full of reports about the treatment of this pathology and, in recent times, when attention has focused on preserving continence and quality of life has become a central issue in medical practice, many new sphincter-saving techniques have been proposed.Few diseases have such a wide range of severity and anatomical variations. The disease spectrum ranges from simple submucosal fistula tracts to an extrasphincteric fistulas involving multiple tracts and, while the treatment of the simplest ones is easy and safe, the more complex fistulas require expert surgeons and often multiple operations.The modern surgical approach to anal fistulas includes several sphincter-saving procedures including the closure of the fistula tract with plugs, fibrin glue, or collagen paste without fistulotomy (i.e., laying open) or by means of fistulectomy (i.e., core-out technique) [1]. However, despite several encouraging reports, though few randomized controlled trials, there is still some skepticism among coloproctologists about the effectiveness of these new sphincter-saving procedures.

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Proctology

Guy¹

2016

Colorectal Surgery

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Fistula-tract Laser Closure (FiLaC™): long-term results and new operative strategies

Cited by 120 publications

References 13 publications

Modern management of perianal fistulas in Crohn’s disease: future directions

Modern management of perianal fistulas in Crohn’s disease: future directions

Anal fistula closure with FiLaC: new hope or the same old story?

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