Results from a novel modification to the ligation intersphincteric fistula tract

American Journal of Surgery
Amir BastawrousKevin Long

Abstract

The ligation of intersphincteric fistula tract (LIFT) procedure for trans-sphincteric fistula-in-ano has been studied with variable success rates compared with initial reports. Failures occur mostly in the intersphincteric wound. Recently, we proposed a modification to LIFT, unroofing the fistula from internal opening to intersphincteric groove, ligating the fistula tract, but preserving the external sphincter. This retrospective review assesses outcomes of patients undergoing the modified LIFT for trans-sphincteric fistulae. Sixty-six modified LIFT procedures were performed. The main cohort consisted of 56 patients, predominantly men (76.7%). Median operative time was 16 minutes. Median follow-up was 20.98 weeks. Overall cure rate was 71.42%, with a recurrence rate of 5.35% and fistula persistence in 16.07%. There was no persistent fecal incontinence. Modified LIFT is a safe procedure that is easily performed, has short operative time, eliminates the intersphincteric space, and has cure rates equal to or better than the original LIFT.

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Citations

Sep 24, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Erin O LangeAlessandro Fichera
Dec 13, 2018·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Ke WenShu-Guang Zhen
Sep 5, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G WilliamsC Maxwell-Armstrong
Feb 2, 2021·The American Surgeon·Yu-Bo LiLi-Ming Pang

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