FiLaCTM, Minimal İnvazif Tedavi Seçeneği Olarak Anal Fistülde Başlangıç Tedavisinde İdeal Tercih mi?

Amaç: Lazer yöntemi (FiLaCTM), son zamanlarda anal fistül tedavisinde minimal invazif tedavi seçeneği olarak karşımıza çıkmaktadır. Anal fistül cerrahisi sonrası anal inkontinans ve fistül nüksü tedaviyi zorlaştıran postoperatif sorunlar olarak karşımıza çıkar. Çalışmamızda FiLaCTM yönteminin anal fistül tedavisinde etkinliğini ve tedavide hangi durumlarda tercih edilmesi ger-ektiğini araştırmayı amaçladık.Materyal ve Metod: Temmuz 2017 ile Ağustos 2018 yılları arasında Derik Devlet Hastanesi’nde FiLaCTM diyot lazer uygulanan 12 hasta çalışmaya dâhil edildi. Hastalar retrospektif olarak, yaş, cinsiyet, inkontinans gelişimi, iyileşme ve işe dönüş zamanı, fistül tipleri, MR bulguları ve kom-plikasyonlar açısından analiz edildi.Bulgular: Çalışmaya alınan hastaların 11’ü erkek 1 kadın olup yaş ortalaması 46 idi. İntraoperatif komplikasyon hiçbir hastada görülmedi. Ortalama takip süresi 13,5 (7-19) ay idi. Hastaların tak-iplerinde 4 (%33,3) hastada tam iyileşme gözlenirken, 8 (%66,7) hastada ise iyleşme sağlanamadı.Sonuç: Anal fistül tedavisi için FiLaCTM prosedürü, güvenli, minimal invaziv, sfinkter koruyucu bir tedavi seçeneği olup düşük etkinliğe sahiptir. Ancak yüksek seviyeli fistüllerde, minimal invazif girişim isteyen hastalarda başlangıç tedavisi olarak tercih edilebilir.

Anahtar Kelimeler:

FiLaCTM, anal fistül, nüks

Is FiLaCTM the Ideal Choice for Initial Treatment of Anal Fistula as a Minimally Invasive Treatment Option?

Aim: The laser method (FiLaCTM) has recently emerged as a minimally invasive treatment option in the treatment of anal fistula. Anal incontinence and fistula recurrence after anal fistula surgery are postoperative problems that complicate the treatment. In our study, we aimed to investigate the effectiveness of the film method in the treatment of anal fistula and in which cases it should be preferred in the treatment. Methods: Twelve patients who underwent FiLaCTM diode laser at Derik State Hospital between July 2017 and August 2018 were included in the study. Patients were analyzed retrospectively in terms of age, gender, development of incontinence, recovery and return to work, fistula types, MRI findings, and complications. Results: 11 of the patients included in the study were male and 1 female and the mean age was 46. Intraoperative complications were not observed in any of the patients. The mean follow-up period was 13.5 (7-19) months. Complete recovery was observed in 4 (33.3%) patients in the follow-ups of the patients, while no improvement was achieved in 8 (66.7%) patients. Conclusion: The FiLaCTM procedure for the treatment of anal fistula is a safe, minimally invasive, sphincter-sparing treatment option with low efficacy. However, it can be preferred as an initial treatment in high-level fistulas and in patients who want minimally invasive intervention.

Keywords:

FiLaCTM, anal fistula, recurrence,

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