Photodynamic therapy for the treatment of complex anal fistula

Arroyo, Antonio; Moya, Pedro; Rodríguez-Prieto, Manuel Ángel; Alcaide, María José; Aguilar, M M Quintana; Bellón, Marta; Perez-Vazquez, M.-T.; Candela, Fernando; Calpena, Rafael

doi:10.1007/s10151-016-1571-y

Cited by 20 publications

(24 citation statements)

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“…Many publications 1,3,4,7,11,16,19,20 have appeared in recent years on the use of low-level laser in the treatment of anal fistula, but all in humans and with a specific product that requires a probe for internal laser application. Despite the good results presented, as also seen in other techniques 9,15 , it is necessary to consider the high cost, the need of hospitalization and the need to close the internal orifice according to the description of the technique.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Low-Level Laser Therapy on Fistula-in-Ano Treatment

Santos

Guimarães

Barros

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Treating anal fistulae is still a great challenge due to the possibility of fecal incontinence after surgery and that the use of laser has been gaining space in medicine, including as an inducing method of healing. Aim: To evaluate the efficacy of low-level laser therapy on fistula-in-ano treatment in rats. Methods: Fifteen male Wistar rats weighing approximately 250-300g were used, which were subjected to the anal fistula induction procedure and after 30 days were distributed into two groups: control group (CG, n=5) and laser group (LG, n=10) observed for another 30 days. In the CG no treatment was performed and, in the LG, low-level laser therapy was applied in fistulous tracts daily. The closure of the fistulous tract, the area of the remaining tract, the inflammatory infiltrate and vascular congestion were evaluated. Results: There was no complete closure of the tract in any of the animals. The mean area of the remaining tract was 847.2 µm2 in the CG and 248.5 µm2 in the LG (p=0.001). The mean inflammatory infiltrate score was 2.4 in the CG and 1.3 in the LG (p=0.0285), while in the evaluation of vascular congestion, 1.6 was observed in the CG and 0.6 in the LG (p=0.031). Conclusions: Low-level laser therapy was able to reduce the area of the fistulous tracts as well as decrease the inflammatory process and local vascular congestion.

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Section: Resultsmentioning

confidence: 99%

Efficacy of Low-Level Laser Therapy on Fistula-in-Ano Treatment

Santos

Guimarães

Barros

et al. 2021

ABCD, arq. bras. cir. dig.

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“…Two studies were excluded20,21 and eight studies were included in our meta‐analysis (Table 1), which included 476 patients who underwent the FiLaC™ procedure for the treatment of perianal fistula [22–29]. Among these patients 63% experienced a successful closure after FiLaC™ and 8% had a postoperative complication.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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Aim Fistula Laser Closure (FiLaC TM) is a novel sphincter-preserving technique that is based on new technologies and shows promising results in repairing anal fistulas whilst maintaining external sphincter function. The aim of the present meta-analysis is to present the efficacy and the safety of FiLaC TM in the management of anal fistula disease. Method The present proportional meta-analysis was designed using the PRISMA and AMSTAR guidelines. We searched MEDLINE, Scopus, clinicaltrials.gov, Embase, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases from inception until November 2019. Results Overall, eight studies were included that recruited 476 patients. The pooled success rate of the technique was 63% (95% CI 50%-75%). The pooled complication rate was 8% (95% CI 1%-18%). Sixty-six per cent of patients had a transsphincteric fistula and 60% had undergone a previous surgical intervention, mainly the insertion of a seton (54%). The majority had a cryptoglandular fistula. Operation time and follow-up period were described for each study. Conclusion FiLaC TM seems to be an efficient therapeutic option for perianal fistula disease with an adequate level of safety that preserves quality of life. Nevertheless, randomized trials need to be designed to compare FiLaC TM with other procedures for the management of anal fistulas such as ligation of intersphincteric fistula tract, anal advancement flaps, fibrin glue, collagen paste, autologous adipose tissue, fistula plug and video-assisted anal fistula treatment.

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“…La fistulotomía es considerada como el mejor tratamiento para fístulas simples 9,10 . En cambio, las fístulas complejas se tratan con "técnicas preservadoras de esfínteres" 13,[24][25][26][27][28][29][30] que intentan encontrar un compromiso entre cicatrización y riesgo de incontinencia. Estas técnicas no alcanzan tasas de curación deseadas y un tratamiento quirúrgico agresivo puede ejercer un impacto negativo en la calidad de vida de los pacientes.…”

Section: Discussionunclassified