Laser closure is a novel sphincter-saving technique for the treatment of anal fistula. The aim of this study was to report middle-term results of laser treatment without closure of the internal orifice and to identify prognostic factors to improve selection criteria and maximize healing. A retrospective observational study was conducted on patients treated with the laser for transphinteric anal fistula. A diode laser emitting laser energy of 12W at a wavelength of 1470 nm was used. The relationship between fistula healing and age, sex, previous fistula surgery, location of the fistula, and length of fistula tract was investigated. A successful outcome was defined by the complete healing of the surgical wound and external opening for at least 6 months. Laser closure is a safe and effective treatment for transphinteric anal fistula. The fistula length is the only significant prognostic factor when closing anal fistulas exclusively with laser: shorter fistulas have a better outcome.

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