FiLaC™ as a last, sphincter-preserving resort for complex perianal fistula

Hous, Nicolas De; Gheldere, Charles de; Broeck, Sylvie Van den; Komen, Niels

doi:10.1007/s10151-019-02070-2

Cited by 10 publications

(19 citation statements)

References 7 publications

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“…The literature search revealed 14 published studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22] on FiLaC after excluding some studies; amongst these were two systematic reviews, both published in 2020 23,24 (see Figure 1 for search strategy). Since these reviews, however, there have been more recent studies 9,10,12,13,[17][18][19][20] including larger series (n>80), 9,13,18 as well as a study assessing FiLaC in solely Crohn's-related perianal fistulas. 20 Table 1 illustrates the studies assessed and their characteristics when evaluating FiLaC for treatment of perianal fistulas.…”

Section: Resultsmentioning

confidence: 99%

“…13,25 The majority of fistulas were complex and these were largely transsphincteric, although the height of the fistula or proportion of sphincter involved was not always reported 13,23,26,27 (Table 2). Four studies reported treatments in patients with secondary extensions, 9,13,19,20 and the remainder either excluded patients with this fistula characteristic or did not specify. Eight studies 9,12,14,15,[18][19][20][21] reported outcomes in patients with Crohn's-related fistula.…”

Section: Dovepressmentioning

confidence: 99%

“…Four studies reported treatments in patients with secondary extensions, 9,13,19,20 and the remainder either excluded patients with this fistula characteristic or did not specify. Eight studies 9,12,14,15,[18][19][20][21] reported outcomes in patients with Crohn's-related fistula. One of these studies assessed sole treatment of Crohn's perianal fistulas 20 in a pilot study of 20 patients; the remaining studies either excluded these patients or included only a few of them (maximum n = 13/ 117, 11% 15 ).…”

Section: Dovepressmentioning

confidence: 99%

“…The internal opening was not closed in the majority of studies. 9,11,13,14,16,17,[20][21][22] Four studies 10,12,18,19 closed the internal opening with sutures and one study reported closure with a combination advancement flap and sutures. 15…”

Section: Technique Variationsmentioning

confidence: 99%

“…Eight studies reported the absence of any morbidity following the procedure. 9,10,[12][13][14]16,19,20,22 Giamundo et al 21…”

Section: Complications/adverse Effectsmentioning

confidence: 99%

See 4 more Smart Citations

Emerging Data on Fistula Laser Closure (FiLaC) for the Treatment of Perianal Fistulas; Patient Selection and Outcomes

Adegbola¹,

Sahnan²,

Tozer³

et al. 2021

CEG

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Fistula laser closure (FiLaC) is a relatively new sphincter-sparing technique in fistula surgery that was initially reported in 2011. It involves the radial dissipation of laser energy in the fistula tract and, through a combination of coagulation and shrinkage of the tract, is proposed to result in progressive sealing of fistulas. Early studies have suggested minimal impact on continence and touted the advantage of minimal morbidity with potential of repeat procedures if the technique fails initially. Despite early promising results, ten years on, questions remain on the technique, patient selection and long-term outcomes. This narrative review assesses the evidence reported to-date of radially emitting laser fistula surgery in the treatment of perianal fistulas.

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