Fistula in AnoLATFIANCT05390151
Laser Assisted Treatment of Fistula In Ano
A study testing Laser treatment of anal fistula and RAF in people with Fistula in Ano and Rectal Fistula, run by University Hospital, Antwerp at 5 sites in Belgium.
Trial summary
Randomised Controlled Trial comparing Laser assisted closure of transsphincteric fistula to the rectal advancement flap. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Fistula in Ano, Rectal Fistula
- What is being tested?
- Laser treatment of anal fistula and RAF
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 176 participants
- Where
- 5 sitesBelgium
- Study dates
- 1 Mar 2022to 1 Mar 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patients with fistula involving more than one-third of the external anal sphincter
- Single, continuous fistula tract at time of inclusion
- Loose seton present in fistula tract for 2 months or more at time of inclusion
- Age ≥ 18
- Able to complete an informed written consent, understand its implications and contents, and participate in follow-up
Who cannot join
- Fistula tract < 1 cm
- Complex fistula tract system (branching of fistula tract inside the sphincter complex)
- Pregnancy
- HIV-positive
- Crohn´s disease, Ulcerative colitis
- Fistula due to malignancy
Show all 10Show fewer
- Tuberculosis
- Hidradenitis Suppurativa
- No internal opening
- Unable to undergo or contraindications to MRI
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
Belgium5 sites, 5 recruiting
- Not yet recruiting
Brussels University Hospital
Brussels, 1090
Jasper Stijns, MD
- Recruiting
Antwerp University Hospital
Edegem, Antwerpen, 2610
Niels Komen, MD PhD, +3238215007, niels.komen@uza.be
- Recruiting
Az St Dimpna Geel
Geel, Antwerpen, 2440
Ben Gys, MD PhD
- Not yet recruiting
Gent University Hospital
Ghent, Oost- Vlaanderen, 9000
Dirk Van De Putte, MD
- Recruiting
Jessa Ziekenhuis Hasselt
Hasselt, Limburg, 3500
Bert Houben, MD
About this study
Official title: LATFIA-trial: Laser Assisted Treatment of Fistula In Ano Randomized Controlled Trial Comparing FiLaCTM to Rectal Advancement Flap
Randomised Controlled Trial comparing Laser assisted closure of transsphincteric fistula to the rectal advancement flap.
Read the detailed description
A prevalent and complex fistula type is the high transsphincteric (TS) fistula. It typically runs through the upper two-thirds of the external anal sphincter (EAS) and is, due to the high risk of fecal incontinence, not suitable for fistulotomy and sphincter sparing treatment is required. To be included in this trial the participants should have a single, continuous TS fistula of cryptoglandular origin, that is treated by loose seton drainage for at least 2 months and is mapped by MRI. Participants with IBD, hidradenitis suppurativa or a malignant fistula will be excluded. Intervention Fistula Laser Closing (FiLaCTM) (Biolitec, Germany) is an endofistular technique, using a radial-emitting laser fiber that emits laser light with a maximum penetration depth of 2 - 3 mm. It destroys both the crypt gland and the additional epithelial layer of the fistula without damaging the sphincter. The fiber is inserted until the internal opening, activated and pulled backwards slowly, allowing the laser to have its effect. The external opening is excised and the internal opening is closed with a single absorbable suture. Rectal advancement flap is currently the gold standard for sphincter sparing treatment of high transsphincteric fistulae. The fistula is cored out and an advancement flap is made of mucosa and submucosa. The opening of the fistula in the flap is excised, the residual internal opening is closed with absorbable suture and the flap is sutured below the fistula to the anoderm. The advancement flap is a difficult technique that requires a relatively large transanal dissection that results in postoperative pain and may lead to disturbances in continence. Preliminary results with the Filac technique show fistula healing rates comparable to the advancement flap. Due to its simplicity, speed and minimal invasiveness the investigators expect a benefit for the participants in terms of postoperative pain, operating time and quality of life.
- Conditions
- Fistula in Ano, Rectal Fistula
- Being tested
- Laser treatment of anal fistula, RAF
- Keywords
- Rectal, Advancement Flap, Laser assisted Fistula Closure, Randomised Control Trial
- Medical subject headings
- Rectal Fistula
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Laser treatment of anal fistulaProcedure or surgery
Also called FiLAC - LAFT
using a radial laserprobe to treat transsphincteric fistula
RAFProcedure or surgery
Also called rectal advancement flap
current golden standard in transsphincteric fistula surgery
| Study group | Role | What they receive |
|---|---|---|
| Laser assisted fistula closure | Active comparator | Group to be actively treated with laser assisted fistula surgery Receives: Procedure: Laser treatment of anal fistula |
| Rectal advancement flap | Active comparator | Group to be actively treated with a rectal advancement flap. Receives: Procedure: RAF |
What is being measured
The primary outcome is the main question the study is designed to answer.
Primary fistula closure after index laser or flap treatment
Success rate (number of patients) of laser/flap treatment defined as full healing (fistula closure) after the index procedure
Measured: 6 months
Secondary outcomes (8)
Secondary Fistula closure
Secondary success rate (number of patients) defined as full healing (fistula closure) after a second procedure (either rectal advancement flap, laser treatment, fistulotomy)
Measured: 6 months
Postoperative Pain
Reported pain after laser or flap treatment: measured using the visual analog scale - VAS where 0 = no pain; 10 = worst pain imaginable,
Measured: 6 months
Postoperative fecal incontinence
Reported fecal incontinence after laser or flap treatment:
measured using the Vaizey score where minimum score 0 = perfect continence; maximum score 24 = totally incontinent)
Measured: 6 months
Postoperative wound complications
Reported wound complications after laser or flap treatment defined as wound dehiscence or bleeding as reported on the adverse event forms
Measured: 6 months
Postoperative Quality of Life
General postoperative well being and ability to partake in daily life and daily tasks (specific role functioning) measured and scored using the SF 36 questionnaire (consisting of 8 weighted scales:
vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role, functioning, and mental health. The lower the score the more disability. The higher the score the less disability)
This outcome is measured in all participants after the initial procedure (index flap or laser treatment) as well as after a second procedure (in case of recurrence)
Measured: 6 months
Primary Recurrence
Number of participants presenting with a clinical recurrence or residual fistula after initial and laser/flap treatment (index procedure)
Measured: 6 months
Secondary Recurrence
Number of participants presenting with a clinical recurrence or residual fistula after the second procedure (Laser - Flap - Fistulotomy - Ligation of the fistula tract, video-assisted fistula treatment)
Measured: 12 months
Identify predictive factors for clinical fistula healing to determine the treatment indications.
This outcome evaluates the correlations between patients'/ fistula's clinical characteristics and primary healing rates
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 May 2022
- Study start1 Mar 2022
- Primary completion1 Sep 2025 (estimated)
- Study completion1 Mar 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Fistula in AnoStudies of the same condition, open and under way.
- More trials run by University Hospital, AntwerpThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 176 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University Hospital, Antwerp
- Sponsor type
- University, hospital or other
- Collaborators
- Universitair Ziekenhuis Brussel, University Hospital, Ghent, AZ St.-Dimpna Geel, Jessa Hospital
- Responsible party
- Sponsor
- Investigators
- Niels Komen, M.D. Phd, Study chair, University Hospital, AntwerpSander Van Hoof, M.D., Principal investigator, University Hospital, Antwerp
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05390151
- Sponsor's protocol ID
- 000202
- Acronym
- LATFIA
- Status last verified
- Mar 2022
- First submitted
- 21 Apr 2022
- Last updated
- 15 Jun 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
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 May;26(5):1038-1046. doi: 10.1111/codi.16951. Epub 2024 Mar 18.
PubMed 38499516
Study at a glance
From the registry record, last updated by the sponsor on 15 Jun 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- LATFIA-trial: Laser Assisted Treatment of Fistula In Ano Randomized Controlled Trial Comparing FiLaCTM to Rectal Advancement Flap
- ClinicalTrials.gov ID
- NCT05390151
- Acronym / sponsor ID
- LATFIA / 000202
- Conditions
- Fistula in Ano, Rectal Fistula
- Keywords
- Rectal, Advancement Flap, Laser assisted Fistula Closure, Randomised Control Trial
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 176 participants (estimated)
- Lead sponsor
- University Hospital, AntwerpUniversity, hospital or other
- Collaborators
- Universitair Ziekenhuis Brussel, University Hospital, Ghent, AZ St.-Dimpna Geel, Jessa Hospital
- Study start
- 1 Mar 2022 (actual)
- Primary completion
- 1 Sep 2025 (estimated)
- Study completion
- 1 Mar 2026 (estimated)
- First posted
- 25 May 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Randomised Controlled Trial comparing Laser assisted closure of transsphincteric fistula to the rectal advancement flap.
Detailed description
A prevalent and complex fistula type is the high transsphincteric (TS) fistula. It typically runs through the upper two-thirds of the external anal sphincter (EAS) and is, due to the high risk of fecal incontinence, not suitable for fistulotomy and sphincter sparing treatment is required. To be included in this trial the participants should have a single, continuous TS fistula of cryptoglandular origin, that is treated by loose seton drainage for at least 2 months and is mapped by MRI. Participants with IBD, hidradenitis suppurativa or a malignant fistula will be excluded. Intervention Fistula Laser Closing (FiLaCTM) (Biolitec, Germany) is an endofistular technique, using a radial-emitting laser fiber that emits laser light with a maximum penetration depth of 2 - 3 mm. It destroys both the crypt gland and the additional epithelial layer of the fistula without damaging the sphincter. The fiber is inserted until the internal opening, activated and pulled backwards slowly, allowing the laser to have its effect. The external opening is excised and the internal opening is closed with a single absorbable suture. Rectal advancement flap is currently the gold standard for sphincter sparing treatment of high transsphincteric fistulae. The fistula is cored out and an advancement flap is made of mucosa and submucosa. The opening of the fistula in the flap is excised, the residual internal opening is closed with absorbable suture and the flap is sutured below the fistula to the anoderm. The advancement flap is a difficult technique that requires a relatively large transanal dissection that results in postoperative pain and may lead to disturbances in continence. Preliminary results with the Filac technique show fistula healing rates comparable to the advancement flap. Due to its simplicity, speed and minimal invasiveness the investigators expect a benefit for the participants in terms of postoperative pain, operating time and quality of life.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Laser assisted fistula closure | Active comparator | Procedure: Laser treatment of anal fistulaGroup to be actively treated with laser assisted fistula surgery |
| Rectal advancement flap | Active comparator | Procedure: RAFGroup to be actively treated with a rectal advancement flap. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients with fistula involving more than one-third of the external anal sphincter
- Single, continuous fistula tract at time of inclusion
- Loose seton present in fistula tract for 2 months or more at time of inclusion
- Age ≥ 18
- Able to complete an informed written consent, understand its implications and contents, and participate in follow-up
Key exclusion criteria (10 listed)
- Fistula tract < 1 cm
- Complex fistula tract system (branching of fistula tract inside the sphincter complex)
- Pregnancy
- HIV-positive
- Crohn´s disease, Ulcerative colitis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Laser treatment of anal fistulaAlso: FiLAC - LAFTusing a radial laserprobe to treat transsphincteric fistula | Procedure or surgery | Laser assisted fistula closure |
| RAFAlso: rectal advancement flapcurrent golden standard in transsphincteric fistula surgery | Procedure or surgery | Rectal advancement flap |
Primary outcome
Primary fistula closure after index laser or flap treatment
Time frame: 6 months
Success rate (number of patients) of laser/flap treatment defined as full healing (fistula closure) after the index procedure
8 secondary outcomes
Secondary Fistula closure
Time frame: 6 months
Postoperative Pain
Time frame: 6 months
Postoperative fecal incontinence
Time frame: 6 months
Postoperative wound complications
Time frame: 6 months
Postoperative Quality of Life
Time frame: 6 months
Primary Recurrence
Time frame: 6 months
Secondary Recurrence
Time frame: 12 months
Identify predictive factors for clinical fistula healing to determine the treatment indications.
Time frame: 6 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jun 2022.
- Derived from this study: PubMed 38499516Gaillard 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 May;26(5):1038-1046. doi: 10.1111/codi.16951. Epub 2024 Mar 18.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Niels Komen, M.D. Phd study chair
University Hospital, Antwerp
Sander Van Hoof, M.D. principal investigator
University Hospital, Antwerp
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Laser treatment of anal fistula and RAF in people with Fistula in Ano and Rectal Fistula, run by University Hospital, Antwerp at 5 sites in Belgium.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 15 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Sander Van Hoof, M.D. (+3238212434, sander.vanhoof@uza.be), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Primary fistula closure after index laser or flap treatment (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05390151, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2022.