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Efficacy of LIFT for recurrent anal fistula
Author(s) -
Lehmann J.P.,
Graf W.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12104
Subject(s) - medicine , surgery , fistula , anal fistula , anal sphincter , incidence (geometry) , ligation , physical examination , sphincter , physics , optics
Aim 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. Method Seventeen patients [nine men; median age 49 (range, 30–76) years] with a recurrent trans‐sphincteric fistula were treated with a LIFT procedure between J une 2008 and F ebruary 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 (3 D ) anal ultrasound. Results 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 de novo faecal incontinence was reported. Conclusion 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.