Reliable treatment of perianal fistulas using laser ablation. Results in 67 patients

Abstract

BACKROUND: We aim to show that fistula ablation with laser (FAL) is a reliable method to repair a perianal fistula, and we share the results of a 24-month follow-up on FAL treatments of different perianal fistula types.

STUDY DESIGN: The FAL procedure was performed using a ceramic diode laser platform (30-50 J/cm of energy at a wavelength of 1470 nm). All operations were performed under spinal anesthesia in the jackknife position.

RESULTS: Of the 67 patients, 48 (71.6%) were male and 19 (28.4%) were female. Of these, 40 (59.7%) had intersphincteric fistulas, 21 (31.3%) had transsphincteric fistulas, 3 (4.47%) had suprasphincteric fistulas, and 3 (4.47%) had extrasphincteric fistulas. Based on perianal fistula disease severity scores, 40 patients (59.70%) experienced complete healing, 10 (14.92%) had persistent symptomatic drainage, 14 (20.89%) had slight drainage with minimal symptoms, and 3 (4.47%) had painful, symptomatic drainage. No major complications were observed in any patient.

CONCLUSIONS: The FAL is a minimally invasive initiative with the lowest morbidity and highest curative recovery rate, especially for simple fistulas.