Background: Fistula tract laser closure (FiLaC) represents a minimally invasive, sphincter-sparing technique for managing fistula in ano with increasing popularity among proctologists. Despite its increasing adoption, significant variations exist in the application of FiLaC in daily practice.

Purpose: The aim of these recommendations was to define some basic principles and recommendations for performing a standard FiLaC procedure.

Methods: The recommendation development group (RDG) consisting of surgeons with experience in the FiLaC were invited to formulate recommendations for the procedure. The recommendations were generated following systematic literature research and discussion amongst experts (expert opinion) where no substantial literature was available. The developed recommendations were voted upon by a panelist via the Delphi process. Consensus was a priori defined as agreement of 75% and above.

Results: The RDG developed 25 recommendations that were voted upon by 21 panelists from 13 nations. Consensus was reached for all 25 recommendations after the first Delphi round.

Conclusion: The FiLaC RDG offers a comprehensive suite of recommendations to enhance the safety and efficacy of standard FiLaC procedures. These 25 detailed recommendations collectively address the full spectrum of FiLaC procedures-from laser settings, preoperative preparations, and perioperative strategies to postoperative care. This coherent framework is anticipated not only to standardize but also to refine the FiLaC technique to ensure best possible surgical outcomes while preserving patient safety.

Keywords: Anal fistula; FiLaC; Fistula in ano; Fistula tract laser closure; Laser Proctology; Sphincter preserving fistula surgery.

© 2025. The Author(s).

背景：背景：

肛瘘激光闭合术（FiLaC）是一种微创、保括约肌技术，用于治疗肛瘘，在结直肠外科医生中越来越受欢迎。尽管其使用率在增加，但在日常实践中应用FiLaC的技术仍然存在很大差异。

目的：

本建议的目的是定义执行标准FiLaC程序的一些基本原则和推荐意见。

方法：

由具有FiLaC经验的外科医生组成的建议开发小组（RDG）被邀请为该程序制定建议。在没有实质性文献的情况下，这些建议是在系统性文献研究和专家讨论的基础上生成的（基于专家意见）。通过德尔菲过程，由评审团对制定的建议进行投票表决。事先定义的一致率标准为75%及以上。

结果：

RDG制定了25项建议，并由来自13个国家的21名评审员进行了投票表决。在第一轮德尔菲过程中，对所有25项建议均达成了共识。

结论：

FiLaC RDG提供了一套全面的建议，以提高标准FiLaC程序的安全性和有效性。这25条详细的推荐意见涵盖了整个FiLaC程序的范围——从激光设置、术前准备和围手术期策略到术后护理。这一连贯框架不仅旨在标准化，而且通过确保最佳外科效果的同时保护患者安全来完善FiLaC技术。

关键词：

肛瘘；FiLaC；肛瘘；瘘管激光闭合术；激光结直肠病学；保括约肌的瘘手术。