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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2025; 17(11): 111285
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.111285
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.111285
Evidence outside the box: Minimally invasive treatment for anal fistula
Kah Hau Luke Chua, Lee Kong Chian School of Medicine, Nanyang Technological University, Mandalay Road 308232, Singapore
Daniel Jin Keat Lee, Department of General Surgery, Khoo Teck Puat Hospital, Yishun Central 768828, Singapore
Author contributions: Chua KHL and Lee DJK reviewed the literature; Chua KHL wrote the manuscript; Lee DJK revised and reviewed the manuscript, and contributed to the editorial concept and design; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel Jin Keat Lee, MD, FRCS (Ed), Department of General Surgery, Khoo Teck Puat Hospital, 90, Yishun Central 768828, Singapore.
Received: June 26, 2025
Revised: July 28, 2025
Accepted: September 22, 2025
Published online: November 27, 2025
Processing time: 151 Days and 12.1 Hours
Revised: July 28, 2025
Accepted: September 22, 2025
Published online: November 27, 2025
Processing time: 151 Days and 12.1 Hours
Core Tip
Core Tip: We present a review summarising the most up-to-date insights into minimally invasive treatment for anal fistulae. Representing new frontiers in fistula treatment, these “sphincter-preserving” modalities seek to balance both recurrence prevention and continence preservation. The newest regenerative solutions, including autologous stem cell therapy and fistula plugs derived from extracellular and synthetic matrices, will be covered, as well as pertinent non-regenerative solutions like fistula laser closure, video-assisted anal fistula treatment, and over-the-scope clips. We consolidated and examined pertinent literature while weighing the pros and cons of each procedure.