Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Anyone had laser (Filac) surgery for anal fistula?



06-20-2018, 10:04 AM   #1
Normanski
 
Join Date: Jan 2018
Location: United Kingdom
Anyone had laser (Filac) surgery for anal fistula?

Hi there,

I've just recently (two days ago) had laser surgery for an anal fistula. I was just wondering if anyone else has had this procedure, and if so what they have experienced post-surgery?

I'm slightly worried because I can still feel the fistula tract and it still feels swollen, is this normal? I was under the impression that it would be removed. Also, I'm experiencing pussy discharge, is this normal and expected?

Thanks
06-22-2018, 01:18 PM   #2
Fistulathens
 
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Hi Normanski,
I had the FiLac surgery twice.

Post surgery I had puss and drainage which did not stop.
My CRS told me that it could last for up to 8 weeks or so. But it never stopped.
FiLac did not work but helped shrink the fistula. And as a result I was able to have a cutting seton surgery in May which seems to have done the job! I am healed now and hopefully will remain so.

Good luck with everything, keep a positive mindset.
Also note that FiLac, even if it does not heal the fistula, it may make it more superficial and easier to treat in the future.

Last edited by Fistulathens; 06-22-2018 at 01:47 PM.
06-22-2018, 01:37 PM   #3
Lynda Lynda
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Hi Normanski.
Puss does not sound good, see your surgeon for a follow-up visit as soon as you can. You may need to have the procedure done again or have a different procedure or need to be prescribed antibiotics.
Wishing you well.
I hope your fistula starts healing soon.
06-27-2018, 06:43 AM   #4
Normanski
 
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Hi Normanski,
I had the FiLac surgery twice.

Post surgery I had puss and drainage which did not stop.
My CRS told me that it could last for up to 8 weeks or so. But it never stopped.
FiLac did not work but helped shrink the fistula. And as a result I was able to have a cutting seton surgery in May which seems to have done the job! I am healed now and hopefully will remain so.

Good luck with everything, keep a positive mindset.
Also note that FiLac, even if it does not heal the fistula, it may make it more superficial and easier to treat in the future.
Hi there,

Thatís great news to hear the you are healed and makes me positive to know that even if the surgery has failed, it has still helped in some capacity. How did you know that the filac surgery didnít work? Did you have a large wound that took some time to heal?

Did the cutting seton solve the problem or did you have to have another filac operation after? My surgeon advised that if this fails I will go through the process again in terms of having a draining seton for 6 months and then filac.

Quick update, itís been just over a week since the surgery now and the wound itself has decreased in size by about half and the swelling has all but gone, so I can just feel the tract and wound now but itís definitely not swollen. Also the drainage has pretty much stopped and Iím in no pain at all, Iím taking this as a sign that the surgery has worked and that Iím healing?

In terms of reoccurrence and failure I assume that if I experience increased drainage and swelling of the fistula tract again then I can assume the surgery has failed? Iíll keep checking the wound each day and feeling around to see if the swelling comes back at all, unless you advise otherwise?

Many thanks and all the best

Last edited by Normanski; 06-27-2018 at 07:13 AM.
06-27-2018, 01:31 PM   #5
Fistulathens
 
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Hi Normanski,
That's good news for you my friend! It sounds to me like you are healed or on your way to healing.
To give you my timeline in regards to FiLac:
- I was diagnosed with Fistula on June 2017
- First Filac October 2017-failed
- Second Filac February 2018-failed but improved the situation and made cutting seton possible.
- Cutting Seton May 2018 - healed (wound closed and no drainage / symptoms since the beginning of June).

I knew that Filac did not work since it never stopped draining post surgery. My drainage post filac never/ever stopped (in neither of the two surgeries). Or to put it another way, in case it stopped for one day or two then the fistula was abscessing. So it was quite easy to diagnose that it failed.

My CRS -who is a real expert at FiLac (huge number of surgeries)- told me during the follow up period that the fistula could be draining for up to 1-2 months post surgery, but that it ought to "dry-up" at some point (within a maximum of two months). So drainage is indeed the best indication in order to assess progress. Once drainage fully stops then the healing process accelerates and is completed.

Your current situation sounds a lot better compared to what I was dealing with. Seems like you have excellent process for 1 week.

You can definitely check the wound yourself. I was worried as well, but my CRS told me that I cannot do any harm by myself (ha-ha).
Good healing & Regards.
06-29-2018, 11:38 AM   #6
Normanski
 
Join Date: Jan 2018
Location: United Kingdom
Wow, just under a year then! it truly is a journey in healing these damn fistulas, so glad to hear you're better now, it must be such a relief and weight of your shoulders.

After one and two weeks in, what was your experience post surgery, were you experiencing pain in general and/or when going to the toilet? And how was the drainage, was it constant and high in volume or every now and again?

Okay that's encouraging, I went back to work a few days ago and have been wearing gauze pads and unfortunately noticed some discharge on the gauze pads once I remove them at the end of the day, i'll keep track of this but I'm worried because I thought the drainage had subsided. Thankfully the wound or swelling hasn't changed so i'm still optimistic, especially if your CRS said it could take up to 1-2 months!

When the fistula abscessed and drained, was this painful and could you notice?

Out of curiosity, how large was your wound post filac surgery? Mine was about the size of a two pound coin, which had me really worried at first, but that has further decreased. Did the wound get smaller for you or stay the same with the continued drainage? My wound has a pink outline and is filled with a thick clear fluid thingy on one side but is starting to scab on the other side, which I guess is good.

Thank you so much for your replies btw, really appreciate it.
06-29-2018, 09:08 PM   #7
Lynda Lynda
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Normanski. Sending you hugs.
Wishing you a speedy recovery.
07-01-2018, 12:09 AM   #8
Fistulathens
 
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Hi Normanski, it is a journey indeed!
It's very difficult to predict the outcome of Filac at the stage you are in my friend. That is because they create a large wound on the surface in order for the healing excretions to escape.
I know how hard it is; but the best thing one can do is to forget about the surgery business for about a month and then go to the CRS.
I did that -sort of-on my 2nd Filac surgery.
So I was just trying to worry less and let my CRS worry about it.
By about a month the outside part of the wound starts to really heal, so the situation can be better appraised by your CRS.
07-01-2018, 12:31 AM   #9
angree rabbit
 
Join Date: Jun 2018
Location: Australia
Hi Normanski,
I had the FiLac surgery twice.

Post surgery I had puss and drainage which did not stop.
My CRS told me that it could last for up to 8 weeks or so. But it never stopped.
FiLac did not work but helped shrink the fistula. And as a result I was able to have a cutting seton surgery in May which seems to have done the job! I am healed now and hopefully will remain so.

Good luck with everything, keep a positive mindset.
Also note that FiLac, even if it does not heal the fistula, it may make it more superficial and easier to treat in the future.



Yes, cutting seton worked for me. All this seton string drainage system & cutting out seems so last decade. They never worked for me 12 years back. ( couple of occasions )

Last edited by angree rabbit; 07-01-2018 at 02:18 AM.
07-01-2018, 02:56 AM   #10
Lynda Lynda
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I had an anal fistulectomy in 1992 and it was cut out. A ridiculously invasive procedure I thought. I am glad you all are getting better treatments/procedures done now-a-days.
07-02-2018, 04:34 PM   #11
Normanski
 
Join Date: Jan 2018
Location: United Kingdom
Hi all,

Quick update - I've been experiencing diarrhea over the past few days and noticed that some stool had passed through the fistula and out of the wound area. Does this mean the surgery has failed? I'm going to try and get in contact with the surgeon who performed the procedure. If so then i'm not too disheartened as this filac op has greatly reduced the swelling and pain.

Lynda Lynda, was the surgery successful?

Thanks
07-02-2018, 06:26 PM   #12
cmack
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I hope things improve, you have my support. I struggled with a few fistulas before. Some were splayed open surgically, in my case they healed fairly well. I'm not sure if it failed with the filac, maybe it's still healing...? I wish you the best. Cheers!
07-02-2018, 06:46 PM   #13
Lynda Lynda
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Join Date: Feb 2018
Location: Arizona
Hi all,

Quick update - I've been experiencing diarrhea over the past few days and noticed that some stool had passed through the fistula and out of the wound area. Does this mean the surgery has failed? I'm going to try and get in contact with the surgeon who performed the procedure. If so then i'm not too disheartened as this filac op has greatly reduced the swelling and pain.

Lynda Lynda, was the surgery successful?

Thanks
Yes,my anal fistulectomy surgery in 1992 was a success.
But when I got home from the surgery/procedure I looked at the area they operated on and was horrified. Yikes. It scared me. Seemed like lots of stitches. I had to do sitz baths every day and then follow-ups with the surgeon. It healed well. I have had two rectal abscess surgeries, in 2002 and 2009, both successfully healed ( but that first abscess was real deep and I had to have it packed with gauze one a day for two weeks.) The second abscess was small and I only had one follow-up with the surgeon. Now when a doctor that has to look "down there", he/she always says "there's s lot of scar tissue." I do not know if that "scar tissue" is JUST from my anal fistulectomy or from the anal fistulectomy AND the two rectal abscess surgeries. No fistulas or abscesses for me during the last 9 years.

Every single persons situation is different, so each person will have a different diagnosis and a different treatment.

I hope that everything works out for you.
A draining fistla is a "pain in the butt" 😳

Take Care. 🌻
07-18-2018, 11:39 AM   #14
Normanski
 
Join Date: Jan 2018
Location: United Kingdom
Hi all,

I hope that you are well.

Itís been exactly a month since the filac surgery and I thought I would give an update.

The fistula wound itself has completely healed over and the draininage has stopped for nearly a week now, all encouraging but I can still feel the fistula tract itself and it feels rather hard/solid still, as if it were still active. My worry is that the wound has healed over the fistula that is still active, any ideas? I canít get through to the doctor who operated on me.

Cheers all
07-18-2018, 03:15 PM   #15
cmack
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Hi, nice to hear from you. It would usually abscess if the fistula had healed on both ends and not the middle. I have had that happen and it hurt, so I don't think it sounds like what happened to me in that instance. I do still have several hard areas from scar tissue that are from years ago... maybe it's that? I would definitely mention it to the doctor as soon as reasonably possible. I hope everything keeps improving, keep in touch.
07-19-2018, 03:37 AM   #16
Fistulathens
 
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Hi Normanski, that sounds like good news - I agree ith Cmack you would have an abscess if the op did not work out.
Filac does not take out (excise) the fistula. Instead it burns and closes it, so my guess from what I've read and discussed about FiLac is that it would be normal for you to still feel scar tissue.
However, the fistula is now most likely "filled" with new tissue and not anymore functioning as a tunnel (fistula). I hope everything goes perfect for you.
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