Ligadura interesfinteriana del trayecto fistuloso (LIFT) como alternativa de tratamiento a una fístula perianal compleja

Abstract

Ligation of intersphincteric fistula tract (LIFT) as an alternative treatment for complex perianal fistula. Introduction: Surgical techniques for complex perianal fistula have high recurrence and fecal incontinence rates. The technique of LIFT (ligation of the intersphincteric fistula tract) has achieved lower rates of recurrence with almost no risk of incontinence according to international reports. However, it is not yet consolidated as a standard technique for this pathology. Objective: To present the results (clinical success and incontinence according to the Wexner scale) of our patients with complex perianal fistula operated with the LIFT technique. Materials and Method: Descriptive study of a non-randomized prospective cohort, with patients operated for complex perianal fistula at the Hospital del Salvador, between 2015 and 2017. Results: 22 operated patients are included. In 77%, therapeutic success is obtained in the first surgery and up to 90% with a second surgery. None of this patients modified their preoperative Wexner. Conclusions: In patients with complex perianal fistula, the LIFT technique is an alternative that offers high cure rates with low risk of fecal incontinence.

The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

“…Thus, to obtain a more fibrous and consistent tract, some authors have suggested the placement and maintenance of a non-cutting seton for a few weeks prior to the definitive ligation of the fistulous tract. 15,[21][22][23] However, some studies question the idea of the seton favoring the development of a more consistent fistulous tract path. 7,24 Furthermore, in the original series of Rojanasakul, with more than 250 patients, the use of a previous seton was not mentioned.…”