Infliximab increases the risk of postoperative complications after restorative proctocolectomy and has altered the surgical approach to ulcerative colitis. Potential benefits of infliximab should be balanced against these risks.
Pouch prolapse is rare, and there are no obvious predisposing factors. Mucosal prolapse may be treated by stool bulking or a local perineal procedure. Full thickness prolapse requires definitive surgery and is associated with risk of pouch loss.
Background fistula-in-ano is a common problem. Ligation of intersphincteric fistula tract (LIFT) is a new addition to the list of operations available to deal with complex fistula-in-ano.
Objective we sought to qualitatively analyze studies describing LIFT for crpytoglandular fistula-in-ano and determine its efficacy.
Data sources MEDLINE (Pubmed, Ovid), Embase, Scopus and Cochrane Library were searched.
Study selection all clinical trials which studied LIFT or compared LIFT with other methods of treatment for anal fistulae, prospective observational studies, clinical registry data and retrospective case series which reported clinical healing of the fistula as the outcome were included. Case reports, studies reporting a combination with other technique, modified technique, abstracts, letters and comments were excluded.
Intervention the intervention was ligation of intersphincteric fistula tract in crpytoglandular fistula-in-ano.
Main outcome measure primary outcome measured was success rate (fistula healing rate) and length of follow-up.
Laparoscopic surgery can be safely performed for rectal cancer, with better postoperative recovery and acceptable early oncological outcomes. Results from large ongoing randomized trials with longer follow-up time are pending to better define oncologic outcomes.
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