A Prospective Comparative Study between Conventional Fistulectomy and Fistula Tract Laser Closure in Fistula in Ano in a Tertiary Care Hospital

Introduction: Perianal sepsis and anal fistulas present significant challenges in colorectal surgery, primarily affecting men aged 30 – 50 years. Aims& Objective: This study compared conventional surgeries, such as fistulectomy, with minimally invasive laser ablation techniques (LAFT) to evaluate effectiveness and patient satisfaction, with the aim of optimizing treatment outcomes while preserving sphincter integrity. Material & Method: A prospective comparative randomized hospital-based study conducted from July 2022 to June 2024, involving 48 patients aged 15-60. The participants underwent either conventional fistulectomy (with or without Seton) or laser ablation of the fistulous tract (LAFT) (isolated or with LIFT). Results: LAFT provided several advantages: shorter operative time (35.75 minutes), reduced hospital stays (2.38 days), lower pain levels (mean VAS 3.37), and quicker recovery (3.6 days). Wound healing was also faster (2.91 weeks), with minimal postoperative complications and no cases of incontinence. Conclusion: Although conventional fistulectomy had a lower recurrence rate, suggesting a higher primary success rate, the benefits of LAFT in terms of pain reduction and recovery time were significant. Therefore, while fistulectomy is effective for uncomplicated cases, LAFT presents a promising alternative that enhances patient satisfaction and outcomes, warranting its early incorporation in treatment protocols for anal fistulas.