Sphincter-saving therapy for fistula-in-ano: long-term follow-up after FiLaC®
| العنوان: | Sphincter-saving therapy for fistula-in-ano: long-term follow-up after FiLaC® |
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| المؤلفون: | A Wolicki, Pia Jäger, M. Senkal, T Deska |
| المصدر: | Techniques in Coloproctology. 25:177-184 |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Anal fistula, medicine.medical_specialty, business.industry, Fistula, Gastroenterology, Fistulectomy, medicine.disease, Colorectal surgery, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Medicine, Sphincter, 030211 gastroenterology & hepatology, Radical surgery, business, Abscess, Abdominal surgery |
| الوصف: | The treatment of anal fistula remains a challenge between maintaining continence and radical surgery to prevent recurrence. Fistula-tract Laser Closure (FiLaC®) is a sphincter-saving technique using a radial emitting laser fibre to close the fistula tract. The aim of this study was to report long-term outcomes in patients who received FiLaC® therapy for transsphincteric and intersphincteric anal fistula between January 2011 and December 2017. A retrospective study was performed on patients who were treated with FiLaC®- for a transsphincteric and intersphincteric anal fistula at our institution between January 2011 and December 2017. In all patients, the FiLaC® procedure was combined with a closure of the internal orifice using a simple 3-0 Z stitch. Patient characteristics, previous proctological history, healing rates, failures and postoperative continence were investigated. The study included 83 patients [mean age 50.01 ± 14.59 years. 64 (77.1%) males] with a mean follow-up period of 41.99 (± 21.59) months (range 4–87 months). Thirteen patients (15.7%) had a recurrent fistula. 65 patients (78.3%) had undergone prior abscess drainage with insertion of a seton. The primary healing rate was 74.7% (62 of 83 patients) overall. Eleven (13.3%) of the 21 patients (25.3%) who failed FiLaC®-therapy underwent a second operation. In eight cases, Re-FiLaC® and in three cases, fistulectomy with closure of the internal orifice was performed. Afterwards 6 (54.5%) of these 11 patients could be considered cured: 3 who had fistulectomy and three who had Re-FiLaC® treatment. The overall healing rate after second FiLaC® was 78.3% (65 of 83 patients) while the overall healing rate for FiLaC® therapy combined with any second procedure was 81.9% (68 of 83 patients). The follow-up period in this group of 11 patients who received re-operation was 38 months (range 13–84 months). Changes in continence occurred in eight patients (9.6%). No patient reported major incontinence postoperatively. The FiLaC® procedure is associated with good healing rates in long-term follow-up and should be considered as a treatment option for transsphincteric and intersphincteric anal fistulae, especially due to the low complication rate and low risk of sphincter injury. |
| تدمد: | 1128-045X 1123-6337 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::e54bc58434e072228d25396c50f98060 https://doi.org/10.1007/s10151-020-02332-4 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........e54bc58434e072228d25396c50f98060 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 1128045X 11236337 |
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