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Closing perianal fistulas using a laser: long-term results in 103 patients

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Date

2018

Author

Terzi, Mustafa Cem
Agalar, Cihan
Habip, Sari
Canda, Aras Emre
Arslan, Naciye Cigdem
Obuz, Funda

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Citation

Mustafa, C. T., & Cihan, A. (2018). Closing Perianal Fistulas Using a Laser: Long-Term Results in 103 Patients. Dis Colon Rectum, 61(5), 00-00.

Abstract

BACKGROUND: Primary closure of the fistula tract using energy emitted by a radial fiber connected to a diode laser is a novel procedure for treating perianal fistulas. OBJECTIVE: The aim of this study was to determine the long-term effectiveness of this new technique. DESIGN: The surgical objective was to seal the fistula tract using laser energy. SETTINGS: The study was conducted at a single day-case surgery center. PATIENTS: Between April 2012 and June 2016, 103 consecutive patients with primary or recurrent perianal fistula underwent a laser closure procedure using a 12-watt laser emitting at a wavelength of 1470 nm. MAIN OUTCOME MEASURES: Patients were classified according to the Park classification, and healing was evaluated based on the perianal fistula disease severity score. RESULTS: Among the 103 patients treated using the laser closure procedure, 82 (80%) were men and 21 (20%) were women. The median age of the patients was 43 years (range, 18-78 y). Fifty-three patients (52%) had previous perianal fistula repair surgery. Based on the Park classification, 56 patients (54%) had intersphincteric fistula, 29 (28%) had transsphincteric fistula, 11 (11%) had suprasphincteric or extrasphincteric fistula, and 7 (7%) had superficial perianal fistula. Based on the perianal disease severity score, 41 patients (40%) obtained overall complete healing, 38 (37%) had persistent symptomatic drainage, 20 (19%) had slight drainage with minimal symptoms, and 4 (4%) had painful symptomatic drainage. LIMITATIONS: This was a retrospective analysis of noncomparative data with a lack of formal prospective continence assessment. CONCLUSIONS: Closure of perianal fistulas using a laser should be considered as a treatment option but with modest expectations. Although our complete healing rate was not as high as in earlier studies, this technique is a reasonable option with nearly no risk of sphincter damage when treating perianal fistulas. See Video Abstract at http://links.lww.com/DCR/A545.

Source

Diseases of The Colon & Rectum

Volume

61

Issue

5

URI

https://doi.org/10.1097/DCR.0000000000001038
https://hdl.handle.net/20.500.12713/791

Collections

  • Makale Koleksiyonu [190]
  • PubMed İndeksli Yayınlar Koleksiyonu [563]
  • Scopus İndeksli Yayınlar Koleksiyonu [709]
  • WoS İndeksli Yayınlar Koleksiyonu [774]



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