Ligation of intersphincteric fistula tract for high trans-sphincteric fistula-in-ano: our experience

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Abstract

Background
Fistula is a common perianal pathology. Management of high fistula is challenging, and up till now, there is no sole gold standard surgery for its management. The ideal treatment must eradicate local infection without endangering anal continence. This encouraged us to conduct this study to evaluate the use of one of the newly developed sphincter-saving procedures, which is ligation of intersphincteric fistula (LIFT) technique for management of high trans-sphincteric fistula, regarding fistula healing, anal continence, and recurrence.
Patients and methods
This study was a prospective study. From January 2016 to January 2017, 26 consecutive patients underwent LIFT procedure for high trans-sphincteric fistulae-in-ano in Damanhur National Institute Hospital and Medical Research Institute Hospital, Alexandria University.
Results
Success rate of the procedure was 80.8% after a follow-up period of 8 months. No change of continence had occurred in any of patients in this study. Relapse of fistula occurred in 11.5% of patients and nonhealing occurred in 7.7% of patients. The time of fistula healing was 20.0–45.0 days with a median of 26.5 days.
Conclusion
LIFT procedure is a safe procedure for management of high trans-sphincteric fistula with promising short-term results and zero incontinence rate.

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