Laser Ablation Versus Conventional Fistulectomy for Uncomplicated Perianal Fistula

Perianal fistula is a common anorectal condition that usually requires surgical treatment. Conventional open fistulectomy has been widely used because of its established effectiveness; however, it may be associated with prolonged recovery. Laser-assisted anal fistula surgery is a newer minimally invasive technique that may offer faster postoperative recovery and less tissue damage.

Published studies have reported conflicting results regarding the superiority of either technique in terms of postoperative recovery and recurrence. Therefore, this randomized controlled trial is being conducted to compare conventional open fistulectomy and laser ablation in patients with uncomplicated perianal fistula.

The study will be conducted at the Department of Surgery, PNS Hafeez Hospital, Islamabad. Seventy-two patients aged 18 to 55 years with uncomplicated perianal fistula will be enrolled and randomized in a 1:1 ratio by paper lottery method into two groups. Group C will undergo conventional open fistulectomy, and Group L will undergo laser-assisted anal fistula surgery.

The primary outcome measures are postoperative recovery time and recurrence of perianal fistula within six months after surgery. Patients will be followed at two weeks and six months postoperatively. The findings of this study may help determine the optimal surgical approach for uncomplicated perianal fistula.

Inclusion criteria

• Age 18 to 55 years.
• Male and female patients.
• Scheduled for surgical treatment of uncomplicated perianal fistula.
• Single fistula tract.
• Less than 30% involvement of the external anal sphincter.
• Penetration of tract limited to subcutaneous tissue.

Exclusion criteria

• Recurrent fistula.
• Complex fistula.
• History of gut malignancy.
• History of inflammatory bowel disease.
• Patients unfit for anesthesia.