Results from a novel modification to the ligation intersphincteric fistula tract

Bastawrous, Amir L.; Hawkins, Melinda; Kratz, Rodney; Menon, Raman; Pollock, D.; Charbel, Jacquelyn M.; Long, Kevin

doi:10.1016/j.amjsurg.2015.01.002

Cited by 18 publications

(12 citation statements)

References 20 publications

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“…One only compared LIFT with a modification of LIFT, rather than a standard treatment, whilst the other two compared LIFT with a mucosal advancement flap. In addition, 18 case series have been reviewed [187,[190][191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206] (Table 3). A number of series reporting fewer than 10 patients were disregarded for the purposes of this position statement.…”

Section: Recommendationmentioning

confidence: 99%

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The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Williams

Tozer

et al. 2018

Colorectal Disease

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Section: Recommendationmentioning

confidence: 99%

“…This modified LIFT was performed on a series 56 patients, with an overall cure rate of 71%. True recurrence (5%) was much less frequent than simple failure of the technique and persistence of an active fistula track after the operation [202]. LIFT has been used as treatment for recurrent fistulas [191].…”

Section: Recommendationmentioning

confidence: 99%

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Williams

Tozer

et al. 2018

Colorectal Disease

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“…As there is no comparison between technical variations of LIFT, determining which variation is superior to others is difficult. Bastawrous et al [21] performed a modified LIFT in which they ligated the fistula tract from the external sphincter level and performed fistulotomy through the internal sphincter. Unlike traditional LIFT surgery, the success rate with this method, where they removed some of the internal sphincters, was 71.42%.…”

Section: Discussionmentioning

confidence: 99%

Complex Anal Fistula: Long-Term Results of Modified Ligation of Intersphincteric Fistula Tract=LIFT

et al. 2020

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T he anal fistula is a permanent infectious tunnel formed between the anal canal and skin in the perianal region. Abscesses and anal fistulas constitute approximately 70% of the suppurative diseases of the perianal region. [1] Perianal abscesses have a nearly 40% chance of causing a perianal fistula. [2] Perianal fistulas occur mostly after perianal abscess drainage due to cryptoglandular drainage. Crohn's disease, trauma, radiation exposure, or malignancy also can be underlying causes. [3] Zanotti et al. [4] reported that the incidence of fistula in the European Union varies between 1.20 and 2.80/10.000 people per year, according to data from four European countries.According to the Parks classification, anal fistulas are divided into four main groups: [5] (i) intersphincteric (extension of the abscess in the intersphincteric plane to the anal edge): (ii) transsphincteric (starts from the intersphincteric area, Objectives: The anal fistula is a permanent infectious tunnel formed between the anal canal and skin in the perianal region. Fistulas are treated by surgery at any stage. Many surgical methods have been reported to treat anal fistula. One of the promising surgical methods with a high success rate is ligation of the intersphincteric fistula tract, which is performed in anatomical spaces without damage to the internal and external sphincters. We evaluated the success rate of a modified ligation of the intersphincteric fistula tract procedure for complex anal fistulas in which the technical differences were minimized by the surgery being performed by the same surgical team. Methods: In this study, Data of the 56 patients were retrospectively collected. Data regarding patient history, visual and digital anal examination, Cleveland Clinic Florida Fecal Incontinence (CCF-FI) score, anal-phase pelvic magnetic resonance imaging (MRI), rectosigmoidoscopy or colonoscopy and anal manometry were recorded. The changes in data recorded during the preoperative and postoperative periods were compared in each other. Results: The mean age of the patients was 41±15.5 years. The number of patients for each fistula type compromised in this study was as follows in accordance with frequency: high transsphincteric fistula, high intersphincteric fistula, and horseshoe abscess. The fistula recurred in seven patients during postoperative follow-up and the success rate of modified LIFT was calculated as 87.5%. The change in the mean±SD preoperative and postoperative CCF-FI scores and anal pressure was not statistically significant. Conclusion: One promising advantage of the ligation of the intersphincteric fistula tract procedure is that it turns a complex fistula into a simple fistula that can be treated with minimal risk of sphincter damage.

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“…Bastawrous A et al 1 improved LIFT surgery to prevent infection of sphincter incision and fistula formation between sphincters. In their surgery, fistula tract was ligated at external sphincter, and internal sphincterotomy was performed along fistula tract.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Ligation of Intersphincteric Fistula Tract for Complex Fistula-in-Ano: Modified Operative Procedure Experience

Wen

Sun

et al. 2018

ABCD, arq. bras. cir. dig.

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Background: It is important but difficult to treat complex fistula-in-ano due to the high recurrent rate and following incontinence. Ligation of the intersphincteric fistula tract (LIFT), a novel surgical procedure with the advantage of avoiding anal incontinence, has a variable success rate of 57-94.4 %. Aim: To evaluate the long-term outcomes of modified LIFT operative procedure - ligation of intersphincteric fistula tract - to treat complex fistula-in-ano. Methods: Retrospective analysis of 62 cases of complex fistula-in-ano. The group was treated with the modified approach of LIFT (curved incision was made in the anal canal skin; purse-string suture was performed around the fistula; the residual fistulas were removed in a tunnel-based way) and had a follow-up time of more than one year. Patient´s preoperative general condition, postoperative efficacy and their anal function were compared. Results: The median age of the participants was 34, and 43 (69.4%) cases were male. Forty-one (66.1%) cases were of high transsphincteric fistula, four (6.5%) cases of high intrasphincter fistula, and 17 (27.4%) cases of anterior anal fistula in female. The median follow-up duration was 24.5 (range, 12-51) months. The success rate in the end of follow-up was 83.9% (52/62). The anorectal pressure and Cleveland Clinic Florida Fecal Incontinence (CCF-FI) evaluated three months before and after the operation did not find apparent changes. Conclusions: Compared with LIFT, the modified LIFT remarkably reduces postoperative failure and the recurrence rate of complex fistula with acceptable long-term outcomes.

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Results from a novel modification to the ligation intersphincteric fistula tract

Cited by 18 publications

References 20 publications

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Complex Anal Fistula: Long-Term Results of Modified Ligation of Intersphincteric Fistula Tract=LIFT

Long-Term Outcomes of Ligation of Intersphincteric Fistula Tract for Complex Fistula-in-Ano: Modified Operative Procedure Experience

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