ArticleCureus2025
A Randomized Controlled Trial Comparing Laser Versus Open Surgical Approaches in the Management of Fistula-in-Ano at a Tertiary Care Center.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07083778 (A Randomized Controlled Trial to Determine the Efficacy and Safety of Laser Versus Open Surgery in the Treatment of Fistula-in-Ano at a Tertiary Care Centre), which is not on this map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial to Determine the Efficacy and Safety of Laser Versus Open Surgery in the Treatment of Fistula-in-Ano at a Tertiary Care Centre
Who cites it
1 citing paper in PubMed.
- Core-Out Fistulectomy Combined With Laser Ablation of the Trans-Sphincteric Fistula Tract: A Pilot Study of Efficacy and Safety.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFistula-in-ano remains a challenging surgical entity due to its high recurrence rate and potential risk of incontinence. This study evaluates and compares the efficacy, safety, and patient-centered outcomes of laser surgery and open surgical procedures.
methodsThis prospective randomized controlled trial (RCT) (ClinicalTrials.gov identifier: NCT07083778) included 100 patients diagnosed with intersphincteric or transsphincteric fistula-in-ano at Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India. Patients were randomized using the even-odd method into two groups: open surgery (n=50) and laser surgery (n=50). Assessed parameters included operative time, postoperative pain (visual analog scale), hospital stay, return to daily activity, healing time, recurrence, incontinence (Wexner score), complications, and patient satisfaction.
resultsThe laser group showed significant advantages in terms of postoperative pain, with 35 patients (70%) reporting only mild pain compared to 15 patients (30%) in the open surgery group (p<0.01). Hospital stay was shorter in the laser group (1.5 ± 0.5 days) compared to the open group (3.8 ± 1.2 days; p<0.001), and return to normal activity was quicker (4.96 ± 0.91 vs. 9.96 ± 0.74 days; p<0.001). However, open surgery demonstrated superior clinical outcomes. Complete healing at three months was achieved in 41 patients (82%) in the open group vs. 35 patients (70%) in the laser group (p=0.16). Recurrence was observed in 15 patients (30%) in the laser group and nine patients (18%) in the open group, approaching statistical significance (p=0.06). Wound infection occurred more frequently in the open group with eight cases (15%) compared to three cases (5%) in the laser group (p=0.034), though all were minor. Incontinence was reported in two patients (5%) and anal stenosis in one patient (2%), all within the open group. Reoperation was more commonly required in the laser group (15 patients, 30%) compared to the open group (nine patients, 18%). Overall, patient satisfaction was slightly higher in the open surgery group (mean score: 6.98 ± 1.96) than in the laser group (6.34 ± 2.29).
conclusionWhile laser surgery offers faster recovery and reduced postoperative morbidity, open surgery remains the more definitive treatment option due to its superior long-term outcomes. Surgical decision-making should be individualized based on fistula complexity and patient-specific factors.
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