Ligation of Intersphincteric Fistula Tract Is Suitable for Recurrent Anal Fistulas from Follow-Up of 16 Months

Yansong Xu, Weizhong Tang, Yansong Xu, Weizhong Tang

Abstract

Since 2007, ligation of the intersphincteric fistula tract (LIFT) for the management of anal fistula was all introduced with initial success and excitement. It remains controversial which surgical procedure is suitable for transsphincteric fistula, especially to complex anal fistula. This retrospective study was designed to evaluate the results in patients with recurrent anal fistula by LIFT. A retrospective study of 55 complex fistula patients who underwent LIFT procedure in a single medical center was analyzed. Patients and fistula characteristics, complications, and recurrences were reviewed. All 55 patients underwent the procedure with a median follow-up of 16 months. Median operative time was 44 (range 23-88) minutes. Of the 55 patients, 33 (60%) healed completely and did not require any further surgical treatment at end of follow-up. Twenty-two (40%) recurrences and six complications were observed. Compared with patients who had undergone more than two surgical procedures, LIFT was more suitable for patients who had undergone one to two surgical procedures, and significant difference was observed in number of operations before LIFT (p = 0.002). Clinicians can consider the use of LIFT for the treatment of recurrent anal fistulas. A larger number of patients and prospective study are needed to be performed.

Conflict of interest statement

There is no conflict of interests regarding the publication of this paper.

References

    1. Wong S., Solomon M., Crowe P., Ooi K. Cure, continence and quality of life after treatment for fistula-in-ano. ANZ Journal of Surgery. 2008;78(8):675–682. doi: 10.1111/j.1445-2197.2008.04616.x.
    1. Rizzo J. A., Naig A. L., Johnson E. K. Anorectal abscess and fistula-in-ano: evidence-based management. Surgical Clinics of North America. 2010;90(1):45–68. doi: 10.1016/j.suc.2009.10.001.
    1. Rojanasakul A., Pattanaarun J., Sahakitrungruang C. Total anal sphincter saving technique for fistula-in-ano; The ligation of 12 intersphincteric fistula tract. Journal of the Medical Association of Thailand. 2007;90(3):581–586.
    1. Han J. G., Yi B. Q., Wang Z. J., et al. Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano. Colorectal Disease. 2013;15(5):582–586. doi: 10.1111/codi.12062.
    1. Wallin U. G., Mellgren A. F., Madoff R. D., Goldberg S. M. Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery? Diseases of the Colon and Rectum. 2012;55(11):1173–1178. doi: 10.1097/DCR.0b013e318266edf3.
    1. Jorge J. M. N., Wexner S. D. Etiology and management of fecal incontinence. Diseases of the Colon & Rectum. 1993;36(1):77–97. doi: 10.1007/BF02050307.
    1. Mushaya C., Bartlett L., Schulze B., Ho Y.-H. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. The American Journal of Surgery. 2012;204(3):283–289. doi: 10.1016/j.amjsurg.2011.10.025.
    1. Lehmann J.-P., Graf W. Efficacy of LIFT for recurrent anal fistula. Colorectal Disease. 2013;15(5):592–595. doi: 10.1111/codi.12104.
    1. Abcarian A. M., Estrada J. J., Park J., et al. Ligation of intersphincteric fistula tract: early results of a pilot study. Diseases of the Colon and Rectum. 2012;55(7):778–782. doi: 10.1097/dcr.0b013e318255ae8a.
    1. Murugesan J., Mor I., Fulham S., Hitos K. Systematic review of efficacy of LIFT procedure in crpytoglandular fistula-in-ano. Journal of Coloproctology. 2014;34(2):109–119. doi: 10.1016/j.jcol.2014.02.008.
    1. Bleier J. I. S., Moloo H., Goldberg S. M. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Diseases of the Colon and Rectum. 2010;53(1):43–46. doi: 10.1007/dcr.0b013e3181bb869f.
    1. Aboulian A., Kaji A. H., Kumar R. R. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Diseases of the Colon and Rectum. 2011;54(3):289–292. doi: 10.1007/DCR.0b013e318203495d.
    1. Tan K.-K., Tan I. J., Lim F. S., Koh D. C., Tsang C. B. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Diseases of the Colon and Rectum. 2011;54(11):1368–1372. doi: 10.1097/dcr.0b013e31822bb55e.

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