Treatment of the fistula tract with laser ablation in high anal fistula

Aim and introduction: Considering the recurrence and fecal incontinence rates in high anal fistulas, surgical treatment of anal fistulas is a challenging process, although many treatments have been defined today. The aim of our study is to evaluate the long-term results of laser ablation of the fistula tract in high anal fistulas.
Material and methods: The files of patients who underwent laser ablation of the fistula tract due to high anal fistula between June 2020 and January 2022 were evaluated retrospectively. Moreover, their postoperative complications, preoperative and postoperative Cleveland fecal incontinence scores (CCFFSI score), postoperative first day and first-week visual analog scale (VAS) scores, follow-up times, and recurrence rates were analyzed.
Results: 26 patients were included in the study. The mean follow-up period was 39.88±14.34 weeks, and the postoperative first and 7th day VAS scores were 4.61±1.41 and 0.8±1.02, respectively. Preoperative and postoperative CCFI scores were calculated as 1.8±1.41, 1.65±1.32, respectively. Recurrence was observed in 7 patients postoperatively. Postoperative anal abscess developed in 1 patient.
Conclusion: Although laser ablation of the fistula tract can be safely performed as a technique that does not affect incontinence, recurrence rates should also be considered. Furthermore, more extensive randomized prospective studies on this technique should be performed.