Ligation of the Intersphincteric Fistula Tract: An Effective New Technique for Complex Fistulas

Bleier, Joshua I. S.; Moloo, Husein; Goldberg, Stanley M.

doi:10.1007/dcr.0b013e3181bb869f

Cited by 180 publications

(129 citation statements)

References 16 publications

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“…Success rates range from 57 to 94% with variable follow-up [12][13][14][15] as shown in Table 1. Overall, a pooled cumulative success rate of 74% can be drawn from this worldwide experience.…”

Section: Discussionmentioning

confidence: 99%

“…The initial report in 2006 from Rojanasakul et al [11] showed a 94% healing rate with a 3-month follow-up. Since then, only a few studies of the use of this technique have been reported, mainly published as abstracts, and with variable success rates from 57 to 89% [12][13][14][15]. This intuitive technique is based on the concept of secure closure of the internal opening and concomitant removal of infected cryptoglandular tissue in the intersphincteric plane.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

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“…Although this is a relatively new procedure, success rates of 57% and 89% have been reported. 33,34 Long-term follow-up is needed to validate these results, but this operation makes sense as a definitive method of closure of transsphincteric fistulas without sphincterotomy.…”

Section: Fistulotomy With Sphincterotomymentioning

confidence: 99%

Anorectal Infection: Abscess-Fistula

Abcarian

2011

Clinics in Colon and Rectal Surgery

179

133

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Anorectal abscess and fistula are among the most common diseases encountered in adults. Abscess and fistula should be considered the acute and chronic phase of the same anorectal infection. Abscesses are thought to begin as an infection in the anal glands spreading into adjacent spaces and resulting in fistulas in 40% of cases. The treatment of an anorectal abscess is early, adequate, dependent drainage. The treatment of a fistula, although surgical in all cases, is more complex due to the possibility of fecal incontinence as a result of sphincterotomy. Primary fistulotomy and cutting setons have the same incidence of fecal incontinence depending on the complexity of the fistula. So even though the aim of a surgical procedure is to cure a fistula, conservative management short of major sphincterotomy is warranted to preserve fecal incontinence. However, trading radical surgery for conservative (nonsphincter cutting) procedures such as a draining seton, fibrin sealant, anal fistula plug, endorectal advancement flap, dermal island flap, anoplasty, and LIFT (ligation of intersphincteric fistula tract) procedure all result in more recurrence/persistence requiring repeated operations in many cases. A surgeon dealing with fistulas on a regular basis must tailor various operations to the needs of the patient depending on the complexity of the fistula encountered. KEYWORDS: Fistula, abscess, anorectal infection, sphincterotomy, fecal incontinenceObjectives: At the completion of this article, the reader is expected to understand the etiology and pathogenesis of an anal abscessfistula, the classification of anal fistulas, and alternative surgical procedures.Anorectal abscess-fistula is one of our most common afflictions. Because of the close association of abscess and fistula in etiology, anatomy, pathophysiology, therapy and morbidity, it is appropriate to consider both entities as one, i.e., abscess-fistula or a fistulous abscess. It is also appropriate to consider an abscess as the acute and a fistula as the chronic state of anorectal suppuration. EPIDEMIOLOGY IncidenceMost publications on the subject reflect authors' experience from a single institution; this does not address the incidence of the disease due to lack of a proper denominator. Also, it is difficult if not impossible to accurately access the incidence of anorectal abscesses because they

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“…14 A success rate of 57% to 94.4% was reported for LIFT procedure in various studies. 15,16 This technique prevents the entry of faecal material into the fistula tract and eliminates the formation of septic nidus in the intersphincteric space to allow healing of the anal fistula. The advantages of the LIFT procedure may include preservation of the anal sphincter, minimal tissue injury, shorter healing time and its being a procedure that is relatively easy to perform.…”

Section: Discussionmentioning

confidence: 99%

Lift procedure for long complex ano-scrotal fistula and review of literature

2016

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Ano-rectal sepsis can be complicated by anal fistula during the acute phase of sepsis or within 6 months thereafter. An anal fistula is characterised by chronic purulent drainage or cyclical pain associated with abscess formation, followed by intermittent spontaneous decompression. A fistula-in-ano can be "simple" or "complex". The goal of surgical management is to effectively eradicate current and recurrent septic foci, associated epithelialized tracts and preserve continence. Study present a case of 22 year old male with long recurrent complex ano-scrotal fistula which was treated by ligation of the intersphincteric fistula tract (LIFT) procedure, preserving the anal continence without leaving any residual septic foci that may lead to recurrence.

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Ligation of the Intersphincteric Fistula Tract: An Effective New Technique for Complex Fistulas

Cited by 180 publications

References 16 publications

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

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

Anorectal Infection: Abscess-Fistula

Lift procedure for long complex ano-scrotal fistula and review of literature

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