title: Photodynamic therapy for the treatment of complex anal fistula.
abstract: BACKGROUND
  Photodynamic therapy (PDT) is a new procedure for the treatment of anal fistula. This preliminary study was designed to investigate the safety and effectiveness of this new technique in the treatment of anal fistula.
  
  
  METHODS
  Ten patients were treated with PDT. Intralesional 5-aminolevulinic acid (ALA) 2% was directly injected into the fistula. The internal and external orifices were closed. After an incubation period of 2 h, the fistula was irradiated using an optical fibre connected to a red laser (MULTIDIODE 630 PDT, INTERmedic, Spain) operating at 1 W/cm for 3 min (180 Joules). Patient demographics, operation notes and complications were recorded.
  
  
  RESULTS
  There were no complications. The average length of patient follow-up was 14.9 months (range 12-20 months). We could observe primary healing in eight patients (80%). Two patients (20%) showed persistence of suppuration after the operation. No patient reported incontinence postoperatively.
  
  
  CONCLUSIONS
  PDT is a potential sphincter-saving procedure that is safe, simple and minimally invasive and has a high success rate.
authors.affiliation: Coloproctology Unit, Department of Surgery, General University Hospital of Elche, C/ Camí de l´Almazara. No 11, 03203, Elche, Spain. arroyocir@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Arroyo
authors.affiliation: Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Moya
authors.affiliation: Department of Dermatology, University Hospital of Leon, Leon, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Rodríguez-Prieto
authors.affiliation: Coloproctology Unit, Department of Surgery, General University Hospital of Elche, C/ Camí de l´Almazara. No 11, 03203, Elche, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Alcaide
authors.affiliation: Coloproctology Unit, Department of Surgery, General University Hospital of Elche, C/ Camí de l´Almazara. No 11, 03203, Elche, Spain.
authors.forename: M M
authors.initials: MM
authors.lastname: Aguilar
authors.affiliation: Coloproctology Unit, Department of Surgery, General University Hospital of Elche, C/ Camí de l´Almazara. No 11, 03203, Elche, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Bellón
authors.affiliation: Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: Pérez-Vázquez
authors.affiliation: Coloproctology Unit, Department of Surgery, General University Hospital of Elche, C/ Camí de l´Almazara. No 11, 03203, Elche, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Candela
authors.affiliation: Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Calpena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D012003:Rectal Fistula / Q000188:drug therapy*; D014031:Tobramycin / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D017319:Photosensitizing Agents; D008795:Metronidazole; D000622:Aminolevulinic Acid; D014031:Tobramycin
keywords: Aminolevulinic acid; Anal fistula; Photodynamic therapy