Clinical and Experimental Gastroenterology (Dec 2021)
Emerging Data on Fistula Laser Closure (FiLaC) for the Treatment of Perianal Fistulas; Patient Selection and Outcomes
Abstract
Samuel O Adegbola,1,2 Kapil Sahnan,1,2 Phillip Tozer,1,2 Janindra Warusavitarne1,2 1Robin Phillips Fistula Research Unit, St Mark’s Hospital and Academic Institute, Harrow, UK; 2Department of Surgery and Cancer, Imperial College, London, UKCorrespondence: Samuel O AdegbolaSt. Mark’s Hospital, Watford Road, Harrow, HA1 3UJ, UKTel +44 208 869 5328Email [email protected]: 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.Keywords: fistula, surgery, FiLaC, fistula laser closure, perianal fistula, perianal Crohn’s disease
