{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:39:16Z","timestamp":1782502756928,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T00:00:00Z","timestamp":1568851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>To validate and analyze the results of intralesional photodynamic therapy in the treatment of complex anal fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>This prospective multicentric observational study enrolled patients treated for complex anal fistula who underwent intralesional photodynamic therapy (i\u2010PDT). The included patients were treated from January 2016 to December 2018 with a minimum follow\u2010up of 1 year to evaluate recurrence, continence and postoperative morbidity. Intralesional 5\u2010aminolevulinic acid (ALA) gel (2%) was injected directly into the fistula. The internal and external orifices were closed. After an incubation period of 2 hours, the fistula was irradiated using an optical fiber connected to a red laser (Multidiode 630 PDT) operating at 1\u2009W\/cm for 3\u2009minutes (180\u2009J).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 49 patients were included (61.2% male). The mean age was 48 years, and the mean duration of fistula was 13 months. Of the fistulas included, 75.5% were medium transphincteric, and 24.5% were high transphincteric. The median fistula length was 4\u2009\u00b1\u20091,14\u2009cm (range: 3\u20135). A total of 41 patients (83.7%) had a previous history of fistula surgery. Preoperatively, some degree of anal incontinence was found in 5 patients (10.2%). No center reported any other procedure\u2010related complications intraoperatively. Phototoxicity was found in one patient. In the first 48\u2009hours after the procedure, fever was reported in 2 patients (4%). At the end of follow\u2010up, total healing was observed in 32\/49 patients (65.3%). No patient reported new incontinence postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>i\u2010PDT could be considered a good choice in patients with complex anal fistulas to avoid surgery and its complications. Lasers Surg. Med. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23162","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T14:36:30Z","timestamp":1568903790000},"page":"503-508","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Photodynamic Therapy for the Treatment of Complex Anal Fistula"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-5175","authenticated-orcid":false,"given":"Antonio","family":"Arroyo","sequence":"first","affiliation":[{"name":"Colorectal Unit, Department of General Surgery, Elche University Hospital Miguel Hern\u00e1ndez University Carrer Almazara, 11 Elche Alicante 03203 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9074","authenticated-orcid":false,"given":"Luis","family":"S\u00e1nchez\u2010Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of General Surgery, Elche University Hospital Miguel Hern\u00e1ndez University Carrer Almazara, 11 Elche Alicante 03203 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Antonio","family":"Parra","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of General Surgery, Reina Sof\u00eda University Hospital UCAM Universidad Cat\u00f3lica de Murcia Av. Intendente Jorge Palacios, 1 Murcia 30003 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Garc\u00eda\u2010Catal\u00e1","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of General Surgery, Elche University Hospital Miguel Hern\u00e1ndez University Carrer Almazara, 11 Elche Alicante 03203 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Pe\u00f1a\u2010Ros","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of General Surgery, Reina Sof\u00eda University Hospital UCAM Universidad Cat\u00f3lica de Murcia Av. 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