Could FiLaC™ be effective in the treatment of anal fistulas? A systematic review of observational studies and proportional meta‐analysis

Frountzas, Maximos; Stergios, Konstantinos; Nikolaou, Charalampos; Bellos, Ioannis; Schizas, Dimitrios; Linardoutsos, Dimitrios; Kontzoglou, Konstantinos; Vaos, George; Williams, Andrew B.; Toutouzas, Konstantinos

doi:10.1111/codi.15148

Cited by 31 publications

(22 citation statements)

References 44 publications

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“…These two concurrently assisted the laser probe to attain primary closure. Common complications after FILAC was pain and discomfort, minor bleeding, fever, and late abscess [ 8 ]. Recovery is achieved within 6 months with no complication reported.…”

Section: Clinical Discussion and Conclusionmentioning

confidence: 99%

Case report: Complex perianal fistula treated with fistula laser closure (FILAC) and suction catheter

Zulkarnain¹,

Soeselo

Suryanto

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance A patient presented with complex perianal fistula treated with fistula laser closure (FILAC) combined with suction catheters. Case presentation Male, 29 years old, presented in our department, presented with complex perianal fistula with a history of fistulectomy and tight seton for 6 months in another health facility. Intraoperative findings were a tract of 4,5 cm long, 4 external openings, and 1 internal opening. Definitive treatment of Fistula Laser Closure (FILAC) with 13-watt power laser diode produces by BIOLITEC German. Conclusion The patient recovers within 6 months. Promising results have been shown by combining FILAC and suction catheter for complex perianal fistula.

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Section: Clinical Discussion and Conclusionmentioning

confidence: 99%

Case report: Complex perianal fistula treated with fistula laser closure (FILAC) and suction catheter

Zulkarnain¹,

Soeselo

Suryanto

et al. 2021

International Journal of Surgery Case Reports

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“…LAFT tedavisi ile anal fistülün iyileşme oranları değişiklikler göstermektedir. 476 hastayı içeren 8 çalışmanın meta-analizinde, fistül traktı Lazer Ablasyonu sonrasında ortalama iyileşme oranı % 63 ve postoperatif komplikasyon oranı %8 olarak bulunmuştur (22,23). Bununla birlikte, yayınlanmış serilerde başarı oranları, büyük yayılma için tek bir bariz neden olmaksızın % 20-%80 arasında önemli ölçüde değişiklik göstermektedir (6,24,25).…”

Section: Discussionunclassified

“…LIFT benzer başarı ve nüks oranlarına sahiptir ancak perinede ilave insizyon gerektirmektedir. VAAFT'den sonra ortalama başarı oranını %76.01 ve ortalama komplikasyon oranını %16.2 gösterdi (22). VAAFT benzer başarı oranına karşın komplikasyon oranı LAFT'a göre daha yüksek olduğu görülmektedir.…”

Section: Discussionunclassified

“…VAAFT benzer başarı oranına karşın komplikasyon oranı LAFT'a göre daha yüksek olduğu görülmektedir. Anal fistülün fistül tıkacı ile tedavisi %50-60'lık bir başarı oranına ve %10-20'lik bir komplikasyon oranına sahiptir (22,29), bu oranlar ile anal fistül tıkacı tedavisinin başarı oranı daha düşük, komplikasyon oranının ise daha yüksek olduğu görülmektedir. Minimal invaziv bir teknik olan LAFT diğer sfinkter koruyucu tekniklerle karşılaştırıldığında inkontinans açısından daha düşük yan etki riskine sahiptir (23).…”

Section: Discussionunclassified

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Anal Fistül Tedavisinde Minimal İnvaziv Seçenek; Fistül Traktının Lazer Ablasyonu, İlk Deneyimlerimiz, Retrospektif Çalışma

Duran

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Objectives: Many methods are used in the surgical treatment of anal fistulas, however new studies are still conducted due to the high risk of recurrence and incontinence. Laser ablation of the fistula tract (LAFT), a new technique, has started to be used as a sphincter-sparing treatment option in the treatment of anal fistulas. LAFT is based on closing the fistula tract by using 3600 circularly radiated laser energy by a radial fiber probe connected to a diode laser source. In this study, we aimed to share the short-term results of the patients to whom we applied LAFT. Materials and Methods:LAFT technique was applied to 33 patients by the same surgeon between September 2017-January 2020. The fiber laser probe was inserted into the fistula tract. The entire fistula tract was closed by applying a radial fiber laser with a wave length of 1470 nm and a power of 13 watt 3600 circularly to the fistula tract.Results: Average follow-up period was 29.97 months (18-45 months). 11(33.33%) of the patients had recurrence. The mean recurrence time was evaluated as 1.75+/-0.52 months. Faecal and gas incontinence are not observed in any patient. Conclusion:Complications of fecal and gas incontinence are rarely observed, since the LAFT technique has minimal effect on the anal sphincter muscles. We recommend the LAFT technique in the treatment of anal fistulas, as it has good functional results in a short time. Long-term and comprehensive clinical studies are needed to demonstrate its efficacy.

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“…LAFT is a method developed by Wilhelm A. to preserve the integrity and continuity of the sphincter and is based on laser probe ablation of the granulation tissue in the fistula canal (Wilhelm, 2011). It has been reported that the LAFT technique is successful in healing anal fistula at rates varying between 40% and 88% (Oztürk and Gülcü, 2014;Wilhelm et al, 2017;Terzi et al, 2018;Brabender et al, 2020;Donmez and Hatipoglu, 2017;Giamundo et al, 2014;Elfeki et al, 2020;Frountzas et al, 2020). There are even clinics that find the technique to be disappointing and abandon the practice (Stijns et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The success of laser ablation of fistula tract (laft) technique in anal fistula treatment: Early results of a tertiary center

Tarim¹,

Derebey²,

Akgün³

et al. 2021

J Exp Clin Med

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Laser Ablation of the Fistula Tract (LAFT) is a newly defined technique for anal fistula treatment. Our aim in this study is to evaluate the effectiveness of the LAFT technique and to discuss the precise indications and limitations of the technique by sharing our own truths and mistakes over our early results. All patients with anal fistulas who were treated LAFT tecnique by same team from April 2019 until March 2020 at the our center, were evaluated in this study, retrospectively. While the patients who failed LAFT were included in the "Reccurrence after LAFT" group, the patients with successful LAFT were included in the "Healing" group. Differences between the groups were investigated. LAFT technique was applied to 19 patients in the specified period. Twelve (63%) of the cases were male and 7 (37%) were female, and the mean age was 45±14.5. The mean postoperative follow-up time was 13±3.4 months. Eleven cases had undergone surgery at least once with the diagnosis of anal fistula. Loose seton was applied in only 4 (25%) cases. It was observed that only 7 (37%) patients recovered with the LAFT technique (Table 1). LAFT was found to be more successful in patients who had never been operated before (p = 0.048, Table 2). In conclusion, LAFT technique is more successful in primary anal fistula cases and this technique should definitely be among the surgical options for anal fistula treatment.

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Could FiLaC™ be effective in the treatment of anal fistulas? A systematic review of observational studies and proportional meta‐analysis

Cited by 31 publications

References 44 publications

Case report: Complex perianal fistula treated with fistula laser closure (FILAC) and suction catheter

Case report: Complex perianal fistula treated with fistula laser closure (FILAC) and suction catheter

Anal Fistül Tedavisinde Minimal İnvaziv Seçenek; Fistül Traktının Lazer Ablasyonu, İlk Deneyimlerimiz, Retrospektif Çalışma

The success of laser ablation of fistula tract (laft) technique in anal fistula treatment: Early results of a tertiary center

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