Evaluation of ligation of intersphincteric fistula tract technique in treatment of simple transsphincteric fistula

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Abstract

Objective
To evaluate the success rate of ligation of intersphincteric fistula tract (LIFT) operation in the treatment of simple transsphincteric anal fistula.
Background
LIFT is a new effective sphincter-preserving technique. One of the main advantages of the technique is the low possibility of an impaired sphincter function (as there is no resection of the sphincter).
Patients and methods
This is a prospective descriptive clinical study of 30 patients with simple transsphincteric anal fistula. In this variety of fistula, the tract passes from the intersphincteric plane through the external sphincter into the ischioanal fossa, and to the skin. Patients with transsphincteric anal fistulas of cryptoglandular origin with no previous surgical interventions were included. Patients with anal fistulas from another sources, such as Crohn’s disease, tuberculosis, anal cancer, and recurrent fistulas, were excluded. All patients underwent the same technique and were evaluated for 6 months postoperatively.
Results
We evaluated 30 patients. Their mean age was 42.1 years. The outpatient follow-up was 6 months. The healing time observed in this study ranged from 5 to 8 weeks after the procedure (mean±SD) 6.47±1.19. A primary healing rate of 80% (24 patients) was observed, and the recurrence rate was 20% (six patients). Recurrence occurred in the incision for ligation of the fistulous tract, that is, the fistula turned into intersphincteric type. The postoperative wound infection occurs in five (16.7%) patients. Postoperative urine retention occurred in one (3.3%) patient. No bleeding occurred in any patient. No patient experienced postoperative incontinence to stool.
Conclusion
LIFT was effective sphincter-preserving technique in the treatment of simple transsphincteric anal fistulas.

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