Short-Term Outcomes of Eldemerdash Modification of LIFT (Ligation of Inter-sphincteric Fistula Track) Technique for High Trans-Sphincteric Fistula, A prospective Pilot Study of A promising Novel Technique
Background: Although ligation of intersphincteric fistula tract (LIFT) technique has been widely accepted as a sphinctersparing technique, fistula recurrence is still high up to 43–60%. We developed a novel technique, Eldemerdash modification LIFT (LIFT-EM), which is based on adding internal fistulotomy, aiming to eradicate the causative cryptoglandular infection and trying to minimize recurrence rates. Patients and Methods: This is a prospective pilot study on 18 patients with high trans-sphincteric fistula diagnosed with preoperative MRI fistulogram. All patients underwent LIFT-EM. Follow-up intervals were 1 day, 1 week, 3, and 6 months. Cleveland Clinic Florida Fecal Incontinence questionnaire was requested from all participants both pre and postoperatively. Postoperative outcomes were assessed in terms of recurrence, change incontinence status perioperative complications. Results: The mean age of study cases was 36.4±6.0 years, ranging between 27 to 45 years. The mean BMI was 35.3±9.5 with males representing all cases. Recurrence/persistence was recorded in only one (5.6%) patient. Pre and postoperative Cleveland Clinic Florida Fecal Incontinence scores were similar. Study variables did not significantly impact recurrence/ persistence. There was a higher mean VAS score at 24h and 1 week in posterior fistula cases, P 0.001. There was a higher mean duration of hospital stay among ASA grade 2 cases (P 0.001). Inversely, patients with previous anorectal abscess had significantly shorter hospital stay (P 0.018). Conclusion: In properly selected cases, LIFT-EM could be a safe and effective sphincter-sparing technique in treating high trans-sphincteric fistula with low recurrence rates. Randomized clinical trials with larger sample and longer followup periods comparing LIFT modifications are encouraged to consolidate our findings.
Qassem, M., Elsharkawy, A., Abdel Hamid, M., & Omar, A. (2025). Short-Term Outcomes of Eldemerdash Modification of LIFT (Ligation of Inter-sphincteric Fistula Track) Technique for High Trans-Sphincteric Fistula, A prospective Pilot Study of A promising Novel Technique. The Egyptian Journal of Surgery, 44(3), 966-975. doi: 10.21608/ejsur.2025.349559.1336
MLA
Mohamed Gamal Qassem; Ahmed Elsharkawy; Mohamed A. Abdel Hamid; Ahmed S. M. Omar. "Short-Term Outcomes of Eldemerdash Modification of LIFT (Ligation of Inter-sphincteric Fistula Track) Technique for High Trans-Sphincteric Fistula, A prospective Pilot Study of A promising Novel Technique", The Egyptian Journal of Surgery, 44, 3, 2025, 966-975. doi: 10.21608/ejsur.2025.349559.1336
HARVARD
Qassem, M., Elsharkawy, A., Abdel Hamid, M., Omar, A. (2025). 'Short-Term Outcomes of Eldemerdash Modification of LIFT (Ligation of Inter-sphincteric Fistula Track) Technique for High Trans-Sphincteric Fistula, A prospective Pilot Study of A promising Novel Technique', The Egyptian Journal of Surgery, 44(3), pp. 966-975. doi: 10.21608/ejsur.2025.349559.1336
VANCOUVER
Qassem, M., Elsharkawy, A., Abdel Hamid, M., Omar, A. Short-Term Outcomes of Eldemerdash Modification of LIFT (Ligation of Inter-sphincteric Fistula Track) Technique for High Trans-Sphincteric Fistula, A prospective Pilot Study of A promising Novel Technique. The Egyptian Journal of Surgery, 2025; 44(3): 966-975. doi: 10.21608/ejsur.2025.349559.1336
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