Laser ablation in fistula-in-ano treatment: A single-center experience

INTRODUCTION: Fistula-in-Ano (FIA) is a frequently encountered condition that can be hard to rectify and, to date, several different treatment options have been developed. In such complex FIA cases, sepsis and anal incontinence are the two most feared complications after fistulotomy. An alternative method that would be able to destroy the epithelial integrity of the fistula tract, while protecting the patient from sepsis and preserving the sphincters was needed, and in response to these requirements, laser ablation therapy was developed. In this study, we share the early results of laser ablation used to treat FIA in our clinic
METHODS: This retrospective cohort study included patients who were treated using laser ablation between November 2018 and January 2021. Only patients with benign isolated anorectal disease were included in the study, while cases of FIA secondary to immunosuppressive conditions such as malignancy and inflammatory bowel diseases were excluded. Post-operative complications and any cases of recurrence and/or reoperation were followed up.
RESULTS: There were no perioperative complications requiring additional intervention in any of the patients. Recurrence was seen in 18 (22.5%) patients during follow-up. The primary recovery rate was 77.5%; secondary recovery rate was 95%.
DISCUSSION AND CONCLUSION: In this study, we found an acceptable primary success rate (77.5%) and a high secondary success rate (95%) for the laser ablation method. With a success rate comparable to other methods, the biggest advantage of laser ablation therapy seen in our study was the lack of major perioperative complications in any of the patients.