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Not yet recruitingNCT07797842Updated Sep 1, 2026

Open Fistulectomy vs. Laser Closure for Low Perianal Fistula

An interventional study of Fistula-tract Laser Closure (FiLaC) and Open Fistulectomy in Perianal Fistula, Fistula-in-Ano and Low Perianal Fistula, sponsored by Assiut University. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-01.

Sponsored by Assiut University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Perianal fistula is an abnormal tunnel connecting the anal canal to the perianal skin, frequently causing chronic pain, discharge, and impaired quality of life. Traditional open fistulectomy is an established treatment with high healing rates, but it leaves an open wound that requires prolonged recovery and carries a risk of anal sphincter injury. Fistula-tract Laser Closure (FiLaC) is a minimally invasive, sphincter-preserving technique that uses laser thermal energy to close the tract from within while minimizing tissue trauma.

This study is a prospective, randomized controlled trial designed to compare the efficacy and safety of open fistulectomy versus laser fistulotomy in adult patients with primary low perianal fistula.

Participants are randomly assigned to one of two surgical treatment groups:

  • Group 1: Laser fistulotomy (FiLaC) using a 1470 nm diode laser probe to seal the tract, combined with internal opening closure.
  • Group 2: Conventional open fistulectomy involving complete excision of the fistula tract, allowing the wound to heal by secondary intention.

Patients are evaluated during surgery and followed postoperatively at 24 hours, 48 hours, 1 week, 2 weeks, 4 weeks, 3 months, and 6 months. The primary goals are to assess fistula healing rates and postoperative pain levels. Secondary goals include evaluating operative time, intraoperative blood loss, wound healing duration, complication rates, time to return to daily activities, fecal continence (measured by the Wexner Continence Score), and quality of life.

02

Conditions studied

  • Perianal Fistula
  • Fistula-in-Ano
  • Low Perianal Fistula

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Keywords

  • FiLaC
  • Laser fistulotomy
  • Open fistulectomy
  • Fistula tract laser closure
  • Sphincter preservation
  • Diode laser
  • Anal incontinence
  • Wexner score
03

In context

Rectal Fistula

169 studies on the registry are indexed under Rectal Fistula; 45 are open to participants now.

This study's planned enrollment of 40 is below the median of 66 across 115 interventional studies indexed under Rectal Fistula.

Browse Rectal Fistula studies →

Lead sponsor

Assiut University is the lead sponsor of 5,078 studies on the registry; 2,178 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult patients aged 18 years and above.
  • Diagnosis of primary (non-recurrent) low perianal fistula (intersphincteric or low transsphincteric involving less than one-third of the external sphincter) confirmed by clinical examination.
  • Fistula tract anatomy confirmed by preoperative endoanal ultrasound (EAUS) and/or pelvic MRI.
  • Fit for surgery under spinal or general anesthesia.
  • Willing and able to provide written .

Exclusion criteria

Exclusion Criteria:

  • Complex or high perianal fistulae (suprasphincteric, extrasphincteric, or involving more than one-third of the external sphincter).
  • Recurrent or previously operated perianal fistulae.
  • Crohn's disease or other inflammatory bowel disease-associated fistulae.
  • Active anorectal sepsis or undrained abscess at the time of enrollment.
  • patients (e.g., /AIDS, long-term systemic therapy, post-organ transplantation).
  • Pre-existing fecal incontinence (baseline Wexner Continence Score > 5).
  • Pregnant or breastfeeding females.
  • Known bleeding disorders or therapeutic anticoagulation that cannot be temporarily safely discontinued.
  • History of prior pelvic irradiation.
  • Inability or unwillingness to comply with the postoperative follow-up protocol.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

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HIV

The human immunodeficiency virus, which weakens the immune system.

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Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

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05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Laser Fistulotomy (FiLaC)

    Patients undergo Fistula-tract Laser Closure (FiLaC™) using a 1470 nm diode laser system. The internal opening is curetted and sutured closed with polyglycolic acid suture. Granulation tissue is debrided with a fistula brush, and a radially emitting laser probe is introduced through the external opening to deliver energy circumferentially (10-14 W) at a continuous withdrawal rate of 1 mm/s to obliterate the tract. The external opening is left open or loosely sutured for drainage.

    Procedure: Fistula-tract Laser Closure (FiLaC)

  • Active comparator
    Open Fistulectomy

    Patients undergo conventional open fistulectomy. The fistula tract is cannulated with a malleable probe, followed by complete surgical excision of the tract and its epithelialized lining using electrocautery and sharp dissection. The surgical wound is left open to heal by secondary intention, with wound edge marsupialization performed as needed to prevent premature skin bridging.

    Procedure: Open Fistulectomy

Interventions

  • ProcedureFistula-tract Laser Closure (FiLaC)

    Debridement of the fistula tract using a fistula brush followed by closure of the internal opening with 2/0 polyglycolic acid suture. Photothermal obliteration of the tract is achieved using a 1470 nm diode laser system with a 360-degree radial emitting fiber delivering energy circumferentially (10-14 W) during steady withdrawal at 1 mm/s.

  • ProcedureOpen Fistulectomy

    Complete surgical excision of the fistulous tract from the external opening to the internal opening using sharp dissection and electrocautery over a probe guide. The resulting wound is left open to heal by secondary intention with wound edge marsupialization performed as necessary.

06

What researchers measure

Primary outcomes

  1. Fistula Healing Rate at 6 Months

    Percentage of participants achieving complete clinical fistula healing, defined as complete epithelialization of the surgical site and external wound with total absence of discharge or purulent drainage on clinical examination, without the need for secondary surgical intervention.

    Time frame: 6 months postoperatively

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Oct 2027, 12 months later.

Of 53 non-industry interventional studies with no phase under Rectal Fistula, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 36. This study's planned 12 months is below that.

Counting every sponsor, half of 57 studies reached it within 27 months; a quarter within 11 and three quarters within 38.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 27, 2026
First posted
Sep 1, 2026
StartEst.
Oct 2026
Primary completionEst.
Oct 2027
CompletionEst.
Nov 2027
Last update
Sep 1, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 1, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07797842
Lead sponsor
Assiut University
Responsible party
Nada Mohamed Abd El Meged (Resident, Assiut University) — Principal investigator
First posted
Sep 1, 2026
Start date
Oct 2026 (estimated)
Primary completion
Oct 2027 (estimated)
Completion
Nov 2027 (estimated)
Last update
Sep 1, 2026

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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