Long-term outcomes of fistula-tract laser closure for complex perianal fistulizing Crohn’s disease

Cao, D.; Wang, X.; Qian, K.; Yang, N.; Xu, K.; Xu, G.; Zhu, M.; Zhang, Y.; Cui, Z.

doi:10.1007/s10151-024-02949-9

Tech Coloproctol

2024

DOI: 10.1007/s10151-024-02949-9

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Long-term outcomes of fistula-tract laser closure for complex perianal fistulizing Crohn’s disease

D. Cao,

X. Wang,

K. Qian

et al.

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2024

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Cited by 1 publication

References 29 publications

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Total fistula volume predicts surgical outcomes in complex perianal fistulizing Crohn’s disease following fistula-tract laser closure: A single center retrospective study

Cao,

Wang,

Zhang

et al. 2024

Preprint

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Backgrounds: This study aimed to identify risk factors influencing long-term treatment outcomes in patients with complex perianal fistulizing Crohn’s disease (pfCD) following fistula-tract laser closure (FiLaC™). Methods: A retrospective analysis was conducted on data from patients with complex pfCD who underwent FiLaC™ from January 2019 to December 2020, including demographics, pharmacological regimens, and pre-operative MRI assessments. Follow-up monitored fistula outcomes such as healing, remission, failure, and recurrence. Results: Among 49 patients followed for an average of 60.0 months, 31 (63.3%) achieved fistula healing, 3 (6.1%) showed improvement, 3 (6.1%) had non-healing, and 12 (24.5%) experienced recurrence. Significant differences were found between healed and unhealed groups in total fistula volume (TFV), number of fistula tracts, and perianal Crohn’s disease activity index (PDAI) (P = 0.036, P = 0.020, and P = 0.041, respectively). Multivariate regression analysis indicated TFV as a significant predictor of healing outcomes (P = 0.013). ROC analysis confirmed its predictive value for fistula healing in complex pfCD, with an area under the curve (AUC) of 0.729 (P = 0.008). The optimal threshold for TFV was 4.81 cm³, with a sensitivity of 61.1% and a specificity of 83.9%. The AUC for recurrence rates was 0.883 (P < 0.001), with the sensitivity and specificity at 83.3% and 83.8%, respectively, using the same threshold for TFV. The Kaplan–Meier survival curve highlighted the predictive potential of TFV for fistula recurrence (P < 0.0001). Conclusions: TFV is an effective predictor for long-term outcomes in patients with complex pfCD following FiLaC™.

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Total fistula volume predicts surgical outcomes in complex perianal fistulizing Crohn’s disease following fistula-tract laser closure: A single center retrospective study

Cao,

Wang,

Zhang

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

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Long-term outcomes of fistula-tract laser closure for complex perianal fistulizing Crohn’s disease

Cited by 1 publication

References 29 publications

Total fistula volume predicts surgical outcomes in complex perianal fistulizing Crohn’s disease following fistula-tract laser closure: A single center retrospective study

Total fistula volume predicts surgical outcomes in complex perianal fistulizing Crohn’s disease following fistula-tract laser closure: A single center retrospective study

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