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Gaillard M, Van den Broeck S, Op de Beeck B, Wouters K, Stijns J, Van de Putte D, Gys B, Houben B, Van Dessel E, Bislenghi G, Komen N. Protocol of the LATFIA trial (Laser Assisted Treatment of Fistula in Ano): a multicentre, prospective, randomized controlled trial comparing fistula-tract laser closure (FiLaC™) with rectal advancement flap for high trans-sphincteric fistulas. Colorectal Dis 2024. [PMID: 38499516 DOI: 10.1111/codi.16951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
AIM Anal fistula is one of the most common anal diseases, affecting between 1 and 3 per 10 000 people per year. Symptoms have a potentially severe effect on a patient's quality of life. Surgery is the mainstay of treatment, aiming to cure the fistula and preserve anal sphincter function. Rectal advancement flap (RAF) is currently the gold standard treatment but has recurrence rates varying between 20% and 50% and might lead to disturbance of continence. The aim of the trial described in this work is to discover if the minimally invasive fistula tract laser closure (FiLaC™) technique could achieve higher healing rates and a better functional outcome than RAF. METHOD We will perform a randomized prospective multicentre noninferiority study of the treatment of high trans-sphincteric perianal fistulas, comparing FiLaC™ with RAF in terms of fistula healing, recurrence rate, functional outcome and quality of life. Primary and secondary fistula healing will be evaluated at 26 and 52 weeks' follow-up. Quality of life will be evaluated using the SF-36 questionnaire, the Faecal Incontinence Quality of Life Scale questionnaire and the Vaizey score at 3, 6, 12 and 26 weeks postoperatively. CONCLUSION High trans-sphincteric fistulas have a potentially severe effect on a patient's quality of life. Classical treatment with RAF is a time-consuming invasive procedure. The LATFIA trial aims to compare FiLaC™ with the gold standard treatment with RAF. In case of noninferiority, FiLaC™ treatment could be standardized as a first line treatment for high trans-sphincteric fistulas. Better conservation of the patient's anal sphincter function could possibly be obtained. Likewise, we will report on the postoperative quality of life when applying these two techniques.
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Affiliation(s)
- Marie Gaillard
- Department of Abdominal Surgery, Antwerp University Hospital, Edegem, Belgium
- Antwerp ReSURG, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Sylvie Van den Broeck
- Department of Abdominal Surgery, Antwerp University Hospital, Edegem, Belgium
- Antwerp ReSURG, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Bart Op de Beeck
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - Kristien Wouters
- Clinical Trial Center, Antwerp University Hospital, Edegem, Belgium
| | - Jasper Stijns
- Department of Abdominal Surgery, University Hospital Brussels, Jette, Belgium
| | - Dirk Van de Putte
- Department of Abdominal Surgery, University Hospital Ghent, Ghent, Belgium
| | - Ben Gys
- Department of Abdominal Surgery, Hospital St. Dimpna, Geel, Belgium
| | - Bert Houben
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
| | - Els Van Dessel
- Department of Abdominal Surgery, GasthuisZusters Hospital, Antwerp, Belgium
| | - Gabriele Bislenghi
- Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - Niels Komen
- Department of Abdominal Surgery, Antwerp University Hospital, Edegem, Belgium
- Antwerp ReSURG, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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