Ligation of the Intersphincteric Fistula Tract (LIFT) Technique in the Treatment of Complex Perianal Fistula: Experience of First 50 Cases

Abstract

Perianal fistula is a common disease and surgery is the only treatment option. Many surgical techniques have been described. Ligation of intersphincteric fistula tract (LIFT) is a sphincter saving surgical technique in which fistula tract is ligated and excised through intersphincteric approach. The aim of study is to present our experience of first 50 LIFT procedures particularly healing rate, recurrence rate and complications from the procedure. This is a prospective observational study started from March 2018 on whom underwent LIFT procedure for primary complex perianal fistula of infective origin at Faridpur Central Hospital and Faridpur Medical College Hospital. In this study, 50 patients (42 male and 8 female) of average age of 39±7.6 years with complex fistula were included. The mean operative time was 34.7±5.67 minutes and most of the fistulas were transsphincteric variety (90%). Median wound healing time was 21.45±6.34 days for intersphincteric wound and 26.78±6.93 days for the external opening of the fistula. Mean follow up period was 10.5 months. Seven patients of our series developed recurrent fistula, making the overall success of 86%. None of the patient in our series developed incontinence. LIFT procedure has the advantage of preservation of anal sphincter, minimal tissue injury, shorter healing time, relatively easy to perform, and high success rate. It's a good choice for treatment of complex perianal fistula.
 Faridpur Med. Coll. J. Jan 2020;15(1): 3-7

LIFT vs Fistulectomy: A Retrospective Cohort Study

“…In regards to the operative time in our study, it was higher in LIFT with the mean of 50.10 minutes and lower in the case of fistulectomy with the mean of 32.14 minutes. Contrarily, the study conducted by SK Biswas 16 in which the mean operative time for LIFT was reported to be 34.7 minutes. Operative timing for LIFT in another study conducted by Vinay G. was reported to be 28.4 minutes 17 .…”

“…However, in a study conducted by Goudar, late recurrence was seen in two completely healed patients at the same sites as the original site in LIFT at follow-up of 10 and 12 weeks 20 . SK Biswas reported seven patients who developed recurrent fistula after LIFT 16 . Faecal incontinence was categorized according to Park's classification.…”