Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study.

Abstract:

BACKGROUND:Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique. METHODS:Between October 2010 and April 2011, 18 patients with 'complex' fistulas underwent LIFT. All patients were enrolled in the study after a physical examination including digital examination and proctoscopy. For the purpose of this pilot study, fistulas were classified as complex if any of the following conditions were present: tract crossing more than 30% of the external sphincter, anterior fistula in a woman, recurrent fistula or pre-existing incontinence. Endpoints were healing time, presence of recurrence, faecal incontinence and surgical complications. RESULTS:Ten patients were men and 8 were women; mean age was 39 years; minimum follow-up was 4 months. Three patients required drainage seton insertion and delayed LIFT. After LIFT, 1 patient experienced haemorrhoidal thrombosis. At the end of the follow-up, 15 patients (83%) healed with no recurrence. Three patients had persistent symptoms and required further surgical treatment. We did not observe postoperative worsening of continence. CONCLUSIONS:Results from our pilot study indicate that this novel sphincter-saving approach is effective and safe for treating complex anal fistula.

journal_name

Tech Coloproctol

authors

Sileri P,Franceschilli L,Angelucci GP,D'Ugo S,Milito G,Cadeddu F,Selvaggio I,Lazzaro S,Gaspari AL

doi

10.1007/s10151-011-0779-0

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

413-6

issue

4

eissn

1123-6337

issn

1128-045X

journal_volume

15

pub_type

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