Uses of FiLaC laser as a sphincter-preserving technique in closure of fistula tract in Upper Egypt

Abstract

Aim Treatment of anal fistula as one of anorectal disease is difficult. Anal incontinence and recurrence of fistula are fearful morbidities of surgeons. Many techniques for sphincter preservation such as internal sphincter fistula tract attachment, anorectal flap application, and bioprosthetic plugs have been tried to overcome the complications. This article aimed to estimate the safety and efficacy of the FiLaC method in the management of fistulous tract. Patients and methods A total of 26 patients (22 males, four females) who underwent FiLaC diode laser treatment between October 2019 and October 2020 were admitted at the Surgical Department, Al Azhar University Hospital, Assiut, and Al-Rowad Hospital, Assiut. They were retrospectively analyzed for age and sex, BMI, American Society of Anesthesiologist score, duration of operation, fistula types, complications, and patient satisfaction. FiLaC a 15-W laser probe with a wavelength of 1470 nm and a power of 100–120 J/cm was applied to the fistulous track under the spinal anesthesia. Results The number of male patients were 22 and female patients were four, and the mean age was 35.55±10.32 years. The mean time of operation was 18.37±5.27 min. Intraoperative complications were not recorded. The period of follow-up was 12 months. A total of 23 (88.46%) patients recovered. There were three (11.53%) failures. Satisfaction score of the patients was 4.62±1.07. Conclusion FiLaC laser for the use of closure of fistulous tract is an effective, safe, minimally invasive technique for preservation of the anal sphincter, with a high success rate.