National observational study about the surgical treatment of anal fistula with laser (the FISTULASER study)

Background Ablation of anal fistula tract using a radial laser‐emitting probe is a sphincter‐preserving technique. Objective The objective of investigating the safety and efficacy of laser treatment for complex anal fistula. Design This was a prospective and observational analysis of the long‐term o...

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Vydáno v:	Colorectal disease Ročník 27; číslo 11; s. e70302 - n/a
Hlavní autoři:	Portilla de Juan, Fernando, Reyes Díaz, María L., Piriz, Ana Huidobro, Delgado, Soledad Oliart, Barrigón, Rosa Pelaez, Bujedo, Lourdes Gomez, Duque, Teresa Calderon, Ochoa, Begoña, Quesada, Carmen, Barea, Rocío Molina, Fuente, Maria Jesús, Agüero, Victor David Briceño, Rodríguez, Carlenny Suero, García, Victoria Maderuelo, Maraver, Eva María Sancho, Angulo, Francisco, Marcos, Nuria Moreno, Pérez, Carmen Ramiro, Fons, Jorge Baixauli, Mercado, Carmen Cecilia, López, Marta Pérez, Martínez, Mª Teresa García, Fernández, Lorans, Moncada, Enrique, Veiga, Pilar Fernández, Mallen, Marivi Duque, Guedea, Manuela Elia, González, Gregorio, Cabello, María Antonia Lequerica
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Wiley Subscription Services, Inc 01.11.2025
Témata:	Ablation Adult Aged Anal Canal - surgery cryptoglandular fistula Fecal incontinence Fecal Incontinence - etiology Female Fistula Fistulae Humans Laser Therapy - adverse effects Laser Therapy - methods laseranal fistula Lasers Male Middle Aged Patients Postoperative Complications - etiology Prospective Studies Rectal Fistula - complications Rectal Fistula - surgery Spain Sphincter Success Surgical drains Treatment Outcome Spain laseranal fistula cryptoglandular fistula
ISSN:	1462-8910, 1463-1318, 1463-1318
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Shrnutí:	Background Ablation of anal fistula tract using a radial laser‐emitting probe is a sphincter‐preserving technique. Objective The objective of investigating the safety and efficacy of laser treatment for complex anal fistula. Design This was a prospective and observational analysis of the long‐term outcomes of 172 patients who underwent laser ablation of the fistula tract. Settings This was a multicentre, single‐arm study, involving 20 Spanish centres. Patients Patients with cryptoglandular anal fistulas with an external orifice, high intersphincteric fistula or low intersphincteric fistula with faecal incontinence, transsphincteric fistula and suprasphincteric fistula. Interventions A probe housing a 12‐watt laser emitting at a wavelength of 1470 nm and an energy level of 100 joule/cm was used. Main Outcome Measures Complete treatment success was defined as the closure of the external opening and the absence of fistula drainage, with closure of the fistula tract confirmed by clinical evaluation. Partial success was defined as the external opening remaining open but without drainage. Surgical complications, including continence disorders, were also assessed. Patients were evaluated at 1, 3, 6, and 12 months after surgery. Results A total of 172 patients underwent laser ablation of the fistula tract with a median age of 51 (43–61) years. The majority of them were men (62,8%). A total of 133 patients (77.32%) were followed up for a minimum of 12 months. The number of patients with complete healing was 59 (44.3%) and partial healing was observed in seven (5.26%). Healing (clinical and radiological) was not achieved in 67 patients (50.37%). Nine reported adverse events. None of the patients experienced permanent anal incontinence. Limitations It is the loss to follow‐up of up to 20% of patients, as many patients do not tolerate waiting within a strict visit schedule. Conclusions Laser ablation of the fistula tract is a sphincter‐preserving procedure with an acceptable long‐term success rate.
Bibliografie:	† Appendix . FISTULASER Study Group Collaborators listed in ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3
ISSN:	1462-8910 1463-1318 1463-1318
DOI:	10.1111/codi.70302