FiLaCTM: The Latest Revolution in Anal Fistula Treatment - A Literature Review of Various Therapeutic Techniques

  • Tony Sukentro EMC Pulomas Hospital, Jakarta, Indonesia
  • Ya Thohir Indonesian Biolite Laser Consultant, Indonesia
  • Reza Yuridian Purwoko President University, Bekasi, Indonesia
  • Asmail PT. Riseta Medica Inovasia, Jakarta, Indonesia
  • Berliano Karvenio PT. Riseta Medica Inovasia, Jakarta, Indonesia
Keywords: FiLaCTM, Anal Fistula Treatment, Therapeutic Techniques.

Abstract

Anal fistula, an abnormal tunnel anal and rectal’s mucosa to surrounding skin in anus or perianal region, has long been considered a complex clinical challenge. This condition often poses a threat in long-term treatment due to the recurrence high risk and incontinence. In this article, we narratively review a number of scientific literatures regarding new treatment techniques which been employed to address anal fistula in the past five years. We objectively evaluate the pros and cons of each technique according to clinical outcomes, and aim to explore the most effective treatment strategy for anal fistula. To date, surgery remains the primary method used to treat anal fistula. However, there has not yet been a single technique that is simple and capable of fully curing complex anal fistulas. In undertaking surgical treatment, both healing outcomes and the protection of anal function must be comprehensively considered.

References

Alam, A., Lin, F., Fathallah, N., Pommaret, E., Aubert, M., Lemarchand, N., Abbes, L., Spindler, L., Portal, A., & de Parades, V. (2020). FiLaC® and Crohn’s disease perianal fistulas: a pilot study of 20 consecutive patients. Techniques in Coloproctology, 24(1), 75–78. https://doi.org/10.1007/s10151-019-02134-3

Alasari, S., & Kim, N. K. (2014). Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract (LIFT). Techniques in Coloproctology, 18(1), 13–22. https://doi.org/10.1007/s10151-013-1050-7

Arroyo, A., Moya, P., Rodríguez-Prieto, M. A., Alcaide, M. J., Aguilar, M. M., Bellón, M., Pérez-Vázquez, M. T., Candela, F., & Calpena, R. (2017). Photodynamic therapy for the treatment of complex anal fistula. Techniques in Coloproctology, 21(2), 149–153. https://doi.org/10.1007/s10151-016-1571-y

Bleier, J. I., & Moloo, H. (2011). Current management of cryptoglandular fistula-in-ano. World Journal of Gastroenterology, 17(28), 3286–3291. https://doi.org/10.3748/wjg.v17.i28.3286

Dango, S., Antonakis, F., Schrader, D., Radzikhovskiy, A., Ghadimi, M. B., & Hesterberg, R. (2017). Long-term efficacy and safety of a nitinol closure clip system for anal fistula treatment. Minimally Invasive Therapy and Allied Technologies, 26(4), 227–231. https://doi.org/10.1080/13645706.2017.1282521

De Hous, N., de Gheldere, C., Van den Broeck, S., & Komen, N. (2019). FiLaCTM as a last, sphincter-preserving resort for complex perianal fistula. Techniques in Coloproctology, 23(9), 937–938. https://doi.org/10.1007/s10151-019-02070-2

Dönmez, T., & Hatipoğlu, E. (2018). Closure of Fistula Tract With FilacTM Laser As a Sphincter Preserving Method in Anal Fistula Treatment. Turkish Journal of Colorectal Disease, 0(0), 0–0. https://doi.org/10.4274/tjcd.06025

Eitan, A., Koliada, M., & Bickel, A. (2009). The use of the loose seton technique as a definitive treatment for recurrent and persistent high trans-sphincteric anal fistulas: A long-term outcome. Journal of Gastrointestinal Surgery, 13(6), 1116–1119. https://doi.org/10.1007/s11605-009-0826-6

Frountzas, M., Stergios, K., Nikolaou, C., Bellos, I., Schizas, D., Linardoutsos, D., Kontzoglou, K., Vaos, G., Williams, A. B., & Toutouzas, K. (2020). Could FiLaCTM be effective in the treatment of anal fistulas? A systematic review of observational studies and proportional meta-analysis. Colorectal Disease, 22(12), 1874–1884. https://doi.org/10.1111/codi.15148

García-Olmo, D., Van Assche, G., Tagarro, I., Diez, M. C., Richard, M. P., Khalid, J. M., van Dijk, M., Bennett, D., Hokkanen, S. R. K., & Panés, J. (2019). Prevalence of Anal Fistulas in Europe: Systematic Literature Reviews and Population-Based Database Analysis. Advances in Therapy, 36(12), 3503–3518. https://doi.org/10.1007/s12325-019-01117-y

Garg, P. (2017). Transanal opening of intersphincteric space (TROPIS) - A new procedure to treat high complex anal fistula. International Journal of Surgery, 40, 130–134. https://doi.org/10.1016/j.ijsu.2017.02.095

Garg, P., Song, J., Bhatia, A., Kalia, H., & Menon, G. R. (2010). The efficacy of anal fistula plug in fistula-in-ano: a systematic review. Colorectal Disease : The Official Journal of the Association of Coloproctology of Great Britain and Ireland, 12(10), 965–970. https://doi.org/10.1111/j.1463-1318.2009.01933.x

Gecse, K. B., Bemelman, W., Kamm, M. A., Stoker, J., Khanna, R., Ng, S. C., Panés, J., Van Assche, G., Liu, Z., Hart, A., Levesque, B. G., & D’Haens, G. (2014). A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn’s disease. Gut, 63(9), 1381–1392. https://doi.org/10.1136/gutjnl-2013-306709

Giamundo, P., Esercizio, L., Geraci, M., Tibaldi, L., & Valente, M. (2015). Fistula-tract Laser Closure (FiLaCTM): long-term results and new operative strategies. Techniques in Coloproctology, 19(8), 449–453. https://doi.org/10.1007/s10151-015-1282-9

Giamundo, P., Geraci, M., Tibaldi, L., & Valente, M. (2014). Closure of fistula-in-ano with laser - FiLaCTM: An effective novel sphincter-saving procedure for complex disease. Colorectal Disease, 16(2), 110–115. https://doi.org/10.1111/codi.12440

Iqbal, A., Ahmed, T., Khan, I., Perveen, S., & Khan, M. I. (2019). Outcome of Use of 1% Silver Nitrate In Patients With Low Lying Perianal Fistula. Journal of Ayub Medical College, 31(3), 355–358.

Limura, E., & Giordano, P. (2015). Modern management of anal fistula. World Journal of Gastroenterology, 21(1), 12–20. https://doi.org/10.3748/wjg.v21.i1.12

Mascagni_OTSC_2018.pdf. (n.d.).

Parkash, S., Lakshmiratan, V., & Gajendran, V. (1985). Fistula‐in‐Ano: Treatment By Fistulectomy, Primary Closure and Reconstitution. Australian and New Zealand Journal of Surgery, 55(1), 23–27. https://doi.org/10.1111/j.1445-2197.1985.tb00849.x

Prosst, R. L., Herold, A., Joos, A. K., Bussen, D., Wehrmann, M., Gottwald, T., & Schurr, M. O. (2012). The anal fistula claw: The OTSC clip for anal fistula closure. Colorectal Disease, 14(9), 1112–1117. https://doi.org/10.1111/j.1463-1318.2011.02902.x

Rojanasakul Md, A., Pattanaarun Md, J., Sahakitrungruang Md, C., & Tantiphlachiva, K. (2007). Case Report Total Anal Sphincter Saving Technique for Fistula-in-Ano; The Ligation of Intersphincteric Fistula Tract. J Med Assoc Thai, 90(3), 581–586. http://www.thaiscience.info/journals/Article/JMAT/10402053.pdf

Sileri, P., Giarratano, G., Franceschilli, L., Limura, E., Perrone, F., Stazi, A., Toscana, C., & Gaspari, A. L. (2014). Ligation of the intersphincteric fistula tract (LIFT): A minimally invasive procedure for complex anal fistula: Two-year results of a prospective multicentric study. Surgical Innovation, 21(5), 476–480. https://doi.org/10.1177/1553350613508018

Tetsuo, Y. (2018). Japanese Practice Guidelines for Anal Disorders. Journal of the Anus, Rectum and Colon, 2, 103–109.

Wilhelm, A., Fiebig, A., & Krawczak, M. (2017). Five years of experience with the FiLaCTM laser for fistula-in-ano management: long-term follow-up from a single institution. Techniques in Coloproctology, 21(4), 269–276. https://doi.org/10.1007/s10151-017-1599-7

Wolicki, A., Jäger, P., Deska, T., & Senkal, M. (2021). Sphincter-saving therapy for fistula-in-ano: long-term follow-up after FiLaC®. Techniques in Coloproctology, 25(2), 177–184. https://doi.org/10.1007/s10151-020-02332-4

Published
2024-05-10
How to Cite
Sukentro, T., Thohir, Y., Purwoko, R. Y., Asmail, & Karvenio, B. (2024). FiLaCTM: The Latest Revolution in Anal Fistula Treatment - A Literature Review of Various Therapeutic Techniques. International Journal of Science and Society, 6(2), 386-393. https://doi.org/10.54783/ijsoc.v6i2.1154