الفهرس | Only 14 pages are availabe for public view |
Abstract A peri-anal fistula is an abnormal communication between the rectum or anal canal and the external peri-anal skin. Anal fistula, with its complicated pathogenesis, has been considered a clinical challenge for centuries. The risk of frequent recurrence and incontinence constitutes a considerable threat in the long-term treatment of anal fistula. Till now, none of the existing treatment options added a paradigm shift in the success rate of peri-anal fistula management highlighting the need for more studies to answer the question of the best treatment modality. This is a prospective clinical trial conducted at General Surgery Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. To the best of our knowledge, this is the first study to compare the outcomes of three different modalities (Fistula Tract Laser Closure, Autologous Fibrin Glue Injection, and Fistulectomy) with the main objective to assess the efficacy of three different modalities in the management of peri-anal fistula. A total of 120 patients were divided equally into three groups. group 1:Procedure used was Laser closure of the anal fistula tract (FiLaC). The FiLaC procedure was performed using a ceramic diode laser platform (12 watts, 1470-nm wavelength). Closing of the internal opening is done the The laser fiber was introduced into the fistula tract via the external orifice using the Selinger maneuver until the internal orifice is found. The fiber delivered laser energy homogenously at 360, causing shrinkage of the fistula tract around the fiber while it is withdrawn at the speed of 1 mm/s. |