Evidence map›Paper›PMID 32770423›Full record

ArticleTechniques in coloproctology2020

Assessing the effectiveness of laser fistulectomy for anal fistula: a retrospective cohort study.

D E Brabender, K L Moran, M Brady, J C Carmichael, S Mills, A Pigazzi, M J Stamos, M D Jafari

Abstract read
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In one paragraph

Article in Techniques in coloproctology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Core-Out Fistulectomy Combined With Laser Ablation of the Trans-Sphincteric Fistula Tract: A Pilot Study of Efficacy and Safety.Medical science monitor : international medical journal of experimental and clinical research · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

D E BrabenderIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
K L MoranIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
M BradyIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
J C CarmichaelIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
S MillsIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
A PigazziIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
M J StamosIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA.
M D JafariIrvine Department of General Surgery, University of California, Irvine Medical Center, 333 City Blvd. West, Suite 850, Orange, CA, 92868, USA. jafarim@uci.edu.ORCID 0000-0002-2793-2719

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaser fistulectomy is a minimally invasive, sphincter-sparing procedure for treatment of anal fistula. In several studies, this method has been shown to be safe and effective, with reported success rates ranging from 40 to 88%. We hypothesized that with longer follow-up, these rates would decrease.

methodsA retrospective case analysis assessing the effectiveness of laser fistulectomy in curing fistula-in-ano tracts within a cohort of patients at a single academic institution was conducted. All patients having laser ablation between March 2016 and July 2018 were analyzed. Cure of the fistula was determined by history and postoperative physical exam, and was defined as complete closure of fistula tract with resolution of symptoms. Secondary symptoms of fecal incontinence, infection, and pain were evaluated.

resultsEighteen patients (10 males, mean age 41 ± 13 years) were analyzed. Transphincteric fistula was the most common type (67%, N = 12). The mean number of previous fistula procedures was 1.33 ± 1.64. There was a 22% (N = 4) success rate at an average postoperative follow-up period of 29 ± 8 months (range 18-46 months). Of those who failed, 64% (N = 9) had a subsequent fistula procedure. There were no cases of fecal incontinence, but 3 cases (17%) of postoperative infection were reported and 8 patients (44%) had a subjective increase in pain at first follow-up appointment.

conclusionsOur data showed a much higher failure rate of laser fistulectomy compared to those reported in the literature. However, the small sample size, a large amount of heterogeneity in our patient population with a mixture of fistula types present, and various laser techniques applied decreased the power of this study.

Indexed as

Fecal IncontinenceRectal FistulaAdultAnal CanalCohort StudiesHumansLasersMaleMiddle AgedOrgan Sparing TreatmentsRetrospective StudiesTreatment OutcomeFiLaC™ procedureFistula-in-anoLaserMinimally invasiveSphincter-saving

Identifiers

PMID32770423

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.