Long-term outcomes of laser therapy for perianal fistulising Crohn’s disease: A single-center retrospective cohort study
Abstract
Background: Perianal fistulizing Crohn’s disease (PFCD) remains therapeutically challenging, with high recurrence rates despite combined medical and surgical management. Laser ablation of the fistula tract has emerged as a sphincter-preserving option; however, long-term data in PFCD are limited. This study evaluated long-term outcomes of laser therapy in patients with PFCD. Methods: This retrospective single-center cohort included consecutive patients with PFCD who underwent laser ablation between January 2015 and December 2020. Clinical healing was defined as complete closure of the external opening without drainage for at least 3 months. Recurrence was defined as reappearance of drainage or fistula at the same site during follow-up. Outcomes included healing, recurrence, complications, and continence status. Results: Eleven patients were included. The median age was 31 years, and the median duration of Crohn’s disease was 9 years. Prior seton placement was performed in 81.8% of patients. The median follow-up was 62 months (range, 26–106). Sustained primary healing was achieved in 63.6% of patients, while 36.4% experienced recurrence. Early postoperative complications occurred in 36.4%, and no late abscess was observed. No long-term incontinence was reported. Conclusions: In this small cohort with extended follow-up, laser ablation achieved sustained healing in approximately two-thirds of patients with PFCD while preserving continence. Although limited by sample size and retrospective design, these findings support laser therapy as a feasible sphincter-preserving option within multidisciplinary management.
Keywords
References
- 1. Tsai L, McCurdy JD, Ma C, Jairath V, Singh S. Epidemiology and Natural History of Perianal Crohn’s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts. Inflammatory Bowel Diseases. 2022;28(10): 1477–1484.
- 2. Yamamoto T, Nakase H, Watanabe K, Shinzaki S, Takatsu N, Fujii T, et al. Diagnosis and Clinical Features of Perianal Lesions in Newly Diagnosed Crohn’s Disease: Subgroup Analysis from Inception Cohort Registry Study of Patients with Crohn’s Disease (iCREST-CD). Journal of Crohn’s and Colitis. 2023;17(8): 1193–1206.
- 3. Karki C, Athavale A, Abilash V, Hantsbarger G, Geransar P, Lee K, et al. Multi-national observational study to assess quality of life and treatment preferences in patients with Crohn’s perianal fistulas. World Journal of Gastrointestinal Surgery. 2023;15(11): 2537–2552.
- 4. Spinelli A, Yanai H, Girardi P, Milicevic S, Carvello M, Maroli A, et al. The Impact of Crohn’s Perianal Fistula on Quality of Life: Results of an International Patient Survey. Crohn’s & colitis 360. 2023;5(3): otad036. doi: 10.1093/crocol/otad036. eCollection 2023 Jul.
- 5. Gecse KB, Bemelman W, Kamm MA, Stoker J, Khanna R, Ng SC, et al. A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn’s disease. Gut. 2014;63(9): 1381–1392.
- 6. Anand E, Pelly T, Joshi S, Shakweh E, Hanna LN, Hart A, et al. Current practice and innovations in diagnosing perianal fistulizing Crohn’s disease (pfCD): a narrative review. Techniques in coloproctology. 2025;29(1): 102.
- 7. Adamina M, Bonovas S, Raine T, Spinelli A, Warusavitarne J, Armuzzi A, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. Journal of Crohn’s and Colitis. 2020;14(2): 155–168.
- 8. Chapuis‐Biron C, Bourrier A, Nachury M, Nancey S, Bouhnik Y, Serrero M, et al. Vedolizumab for perianal Crohn’s disease: a multicentre cohort study in 151 patients. Alimentary Pharmacology & Therapeutics. 2020;51(7): 719–727.
Details
Primary Language
English
Subjects
Clinical Sciences (Other)
Journal Section
Research Article
Authors
Çağrı Bilgiç
*
0000-0002-4006-1583
Türkiye
Erman Sobutay
0000-0002-5735-2723
Türkiye
Salih Boluk
0000-0002-6617-5853
Türkiye
Barış Bayraktar
0000-0002-4111-0885
Türkiye
Publication Date
July 30, 2026
Submission Date
April 14, 2026
Acceptance Date
June 16, 2026
Published in Issue
Year 2026 Volume: 40 Number: 3