Efficacy of LIFT for recurrent anal fistula. (25th April 2013)

• Record Type: Journal Article
• Authors: Lehmann, J.‐P.; Graf, W.
• Is Part Of: Colorectal disease. Volume 15:Number 5(2013)
• Page Start: 592
• Page End: 595
• Publication Date: 2013-04-25
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12104
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" xml:lang="en" id="codi12104-abs-0001"> <title>Abstract</title> <sec id="codi12104-sec-0001" sec-type="section"> <title>Aim</title> <p>Ligation of the intersphincteric fistula tract (LIFT) is a novel sphincter‐preserving technique for anal fistula. This pilot study was designed to evaluate the results in patients with a recurrent fistula.</p> </sec> <sec id="codi12104-sec-0002" sec-type="section"> <title>Method</title> <p>Seventeen patients [nine men; median age 49 (range, 30–76) years] with a recurrent trans‐sphincteric fistula were treated with a LIFT procedure between June 2008 and February 2011. All were followed prospectively for a median of 16 (range, 5–27) weeks with clinical examination. Fifteen followed for 13.5 (range, 8–26) months by clinical examination also had three‐dimensional (3D) anal ultrasound.</p> </sec> <sec id="codi12104-sec-0003" sec-type="section"> <title>Results</title> <p>The duration of the procedure was 35 (range, 18–70) min. One patient developed a small local haematoma and one had a subcutaneous infection, but otherwise there was no morbidity. At follow up, 11 (65%) patients had a successful closure, two (12%) had a remaining sinus and four (23%) had a persistent fistula. The incidence of persistent or recurrent fistulae at 13.5 months was six (40%) of 15 patients. No <italic>de novo</italic> faecal incontinence was reported.</p> </sec> <sec id="codi12104-sec-0004" sec-type="section"> <title>Conclusion</title> <p>LIFT is a safe procedure for patients with recurrent anal fistula, with healing at short‐term and medium‐term follow‐up comparable with or superior to that of other sphincter‐preserving techniques. Larger studies with a longer follow up are needed to define the ultimate role of LIFT in patients with recurrence.</p> </sec> </abstract>