Open fistulectomy with sphincter fixation for anal fistula

Abé, Tatsuya; Kunimoto, Masao; Hachiro, Yoshikazu; Ebisawa, Yoshiaki; Hishiyama, Houhei; Abe, Seishu

doi:10.4236/ojgas.2013.34037

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Regarding the occurrence of fecal incontinence in the present study according to Fecal Incontinence Severity Index [8] was 2% patients in fistulotomy and 4% in fistulectomy group that came in agreement of this recent study from Japan that reported temporary minor incontinence of 4% of fistulectomy patients [12]. Another recent study found that fistulectomy is associated with a higher rate of incontinence 50% versus 25% in fistulotomy since muscle separation necessarily occurs after excision of the complete tract [13].…”

Section: Discussionsupporting

confidence: 90%

“…According to previous studies, fistula recurrence developed in 4.5-6% of patients treated with fistulotomy and in 6.8% of fistulotomy patients [9,12,21,22] while in other studies, no patient developed recurrence during the follow-up period of twelve weeks [6,11]. However, the duration of observation in the present study was not sufficient to draw any definite correlation with respect to recurrence [11].…”

Section: Discussioncontrasting

confidence: 68%

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Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

Saber¹

2016

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Abstract:Introduction: Anal fistulae are still negatively influencing the patient's quality of life by causing minor pain, social hygienic embarrassment, and in severe cases, frank sepsis. Although a number of surgical techniques have been proposed to treat this condition, there is still no single ideal technique for the treatment of this disease. Generally, fistulectomy is an adequate surgical procedure for the treatment of a simple or low transsphincteric fistula while others reported that fistulotomy continues to have excellent results. Patients and Methods: This study represented parallel prospective randomized clinical trial where 200 patients were divided randomly into two main groups; A and B. Group A patients were subjected to fistulotomy and those of group B were subjected to fistulectomy for low anal fistulae. The study included all patients having low anal fistulae complicating perianal abscesses. Patients with high fistulae and patients with multiple external openings were excluded. The primary end point was anal incontinence and the secondary end points were time off from work, postoperative pain, wound discharge, wound healing and patients' satisfaction. Results: The mean operative time, time taken for wound discharge to cease and time taken for complete healing was significantly less in patients of group A. Regarding the occurrence of fecal incontinence, no permanent cases were reported in our series but temporary incontinence was observed in 2 patients in fistulotomy group while in fistulectomy group there were 4 patients. Therefore, the overall patient satisfaction mean values were 90.6 ± 8.87and 85.6 ± 13.2 for patients in group A and B respectively with statistically insignificant distribution. Conclusion: Fistulotomy could be used as a primary treatment of low anal fistula as being safe and simple to perform with good patient's satisfaction as regard postoperative pain and outcome.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 68%

Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

Saber¹

2016

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“…Traditionally anal fistulas were treated by fistulotomy or fistulectomy, which have both proven to be effective, however, even for simple fistulas, they may result in some degree of incontinence in approximately 12%-39% of patients, need prolonged time for wound healing and associated with postoperative scaring and anal deformity. [6][7][8] To avoid these complications other options for treatment of anal fistula were developed, including seton placement, anal fistula plug, fibrin glue injection, Radiofrequency ablasion, endorectal advancement flap (ERAF) and ligation of the intersphincteric fistula tract (LIFT). [9][10][11][12][13][14] The aim of this study was to evaluate the efficacy and safety of ligation of the intersphincteric fistula tract as a surgical management of anal fistula.…”

Section: Introductionmentioning

confidence: 99%

Ligation of the intersphincteric fistula tract technique in the treatment of anal fistula

Younes

2017

Int Surg J

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Background: Management of anal fistula is a challenging issue in surgical practice. No single technique is appropriate for treatment of all types of fistulas. The aim of this study was to evaluate the efficacy and safety of a new sphincter-sparing technique: ligation of the intersphincteric fistula tract (LIFT) for management of anal fistula.Methods: Over a period of 18 months from January 2015 to June 2016 twenty-one patients (12 males and 9 females) with transsphincteric anal fistula were treated with the LIFT procedure. Patients were followed up for at least six months postoperatively for fistula recurrence, rate of wound healing and effect on fecal continence.Results: Fistula healing rate was (90.5%); recurrence rate was 9.5% in the form of down staging to intersphincteric fistulas. Mean time of healing of intersphincteric wound was 32±7.4 days (ranged from 17 to 58 days). Mean time of healing of the external opening wound was 27±5.8 days (ranged from 19 to 56 days). No postoperative changes in fecal continence.Conclusions: LIFT operation is a safe and effective management of transsphincteric anal fistula, this technique has high healing rate with no effect on fecal continence.

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“…The aim of surgery in anal fistula is to eradicate infection and promote healing, whilst preserving anal sphincter complex and full continence 5 . Until now most of the fistulas were treated by fistulotomy or fistulectomy, which have both proven to be effective, however, even for simple fistulas, they may result in some degree of incontinence in approximately 12-39% of patient, need prolonged time for healing and associated with progressive scarring and anal deformity [6][7][8] . To avoid these complications, other options for surgical treatment of anal fistulas were developed including endorectal advancement flap, excision and closure of internal opening, injection of fibrin or cyanoacrylate glue, insertion of fistula plug, video assisted anal fistula treatment (VAAFT) and ligation of intersphincteric fistula tract (LIFT) 6,9 .…”

mentioning

confidence: 99%

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

Biswas¹,

Rahman²,

Hossain³

et al. 2020

Faridpur Med Coll J

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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

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Open fistulectomy with sphincter fixation for anal fistula

Cited by 3 publications

References 14 publications

Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

Ligation of the intersphincteric fistula tract technique in the treatment of anal fistula

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

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