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Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS)
Volume-11 | Issue-10 | 1028-1030
Original Research Article
Predictive Factors for the Success of the Filac Technique
M. Tamdaoui, S. Mechhor, M. Cherkaoui Malki, H. El Bacha, N. Benzzoubeir, I. Errabih
Published : Oct. 30, 2025
DOI : https://doi.org/10.36348/sjmps.2025.v11i10.013
Abstract
The FiLaC™ (Fistula Laser Closure) technique has emerged as a valuable sphincter-preserving option for the treatment of cryptogenic anal fistulas, combining efficacy with functional safety. This retrospective study was conducted at the Hepato-Gastroenterology and Proctology Department of Ibn Sina University Hospital, Rabat, between January 2023 and January 2025. Twenty-five patients with cryptogenic anal fistulas underwent treatment using the FiLaC™ procedure, following initial drainage with a seton. Fistulas secondary to Crohn’s disease, tuberculosis, or malignancy were excluded. Cure was defined as complete closure of the fistulous tract and both orifices without recurrence during 24 months of follow-up. The mean age was 45.3 years, with a slight male predominance. Transsphincteric fistulas were the most frequent (44%), and the overall success rate reached 84%, without any case of postoperative incontinence. Univariate analysis showed that a short fistulous tract and a small internal opening were associated with better outcomes (p = 0.036 and p = 0.042, respectively). In multivariate analysis, only the short fistula tract remained a significant independent predictor of success (p = 0.04; OR = 5.12). Recurrent cases were successfully managed with a second FiLaC™ session. The technique was well tolerated and reproducible, with mean energy delivery of 699 Joules and an average fiber withdrawal time of 61.6 seconds. These results confirm that FiLaC™ is a minimally invasive and reliable technique for the management of cryptogenic anal fistulas, offering a high healing rate and optimal preservation of continence. The short length of the fistulous tract appears to be the most decisive predictive factor of long-term success.
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