Value of Laser Ablation in Treatment of Non-Branching Perianal Fistula: Systematic Review and Meta-Analysis

Abstract Background: Perianal fistula is a common anorectal disease that is associated with a decreased quality of life. Despite the advances made in recent years, the treatment of perianal fistula remains a challenge due the difficulty of maintaining continence while preventing recurrence. Aim of Study: To do a systematic search and meta-analysis of the available literature to assess the outcome of FiLaC in the treatment of non-branching perianal fistula. The main objective is to learn about the healing rates and complications associated with FiLaC to reach a conclusion about its overall safety and efficacy. Subjects and Methods: In the current systematic review meta-analysis, a total of 14 studies were included with a total of 809 patients, out of them 11 studies were retrospective, 1 prospective study, 1 cohort study and 1 case series. Results: Pain post-operative assessed in 5 studies with event rate 9.5% and significant heterogeneity between studies. Success assessed in 14 studies with event rate 52.9% and significant heterogeneity between studies. Failure assessed in 14 studies with event rate 45.955% and significant hetero-geneity between studies. Complications assessed in 14 studies with event rate 2.7% and significant heterogeneity between studies. Data Sources: Medline databases (PubMed, Medscape, Science Direct. EMF-Portal) and all materials available in the Internet till 2022. Conclusion: FiL aC is a promising, sphincter-saving technique for the treatment of perianal fistula. It has proven efficacy with more than half of the patients achieving complete healing after its primary application. The main advantage of FiL aC is the good safety profile with very few minor com-plications and almost no negative effects on continence.