Groupe Hospitalier Paris Saint-Joseph, service de gastro-entérologie. 185, rue Raymond Losserand, 75 014 Paris, France
Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bêlas, Service de proctologie médico-chirurgicale, 185, rue Raymond Losserand, 75 014 Paris, France
The treatment of anal fistula is a real challenge of anal surgery because of a significant risk of failure or recurrence and especially of anal incontinence. Fistulotomy, in its different forms, is the treatment of choice but alternatives are sometimes necessary in cases of risk on anal continence. These alternatives, called sphincter-saving procedures are numerous, but their success rates are lower than the fistulotomy. The FiLaC™ (Laser Fistula Closure) is a new and simple technique of anal fistula treatment consisting on “burning” the fistula tract radially with laser. Literature is still poor with some open and heterogeneous studies, but their results are encouraging, with a success rate ranging from 70% to 80% without negative impact on the anal continence. Our own experience is going in the same direction with 89% of cure in the short term. More rigorous studies with a larger number of patients are needed to support these promising preliminary results of FILAC™, compare the technique with other sphincter-saving procedures and define its place in the therapeutic strategy.