Feasibility of ambulatory surgery for anal fistula with LIFT procedure

Abstract

Background Ambulatory surgery maintains the advantages of a more rapid return to work and overall reduced hospital costs. The specific impact of ambulatory surgery for anal fistula using the LIFT procedure (ligation of the intersphincteric fistula tract) is presented. Methods A total of 218 consecutive patients with anal fistula who underwent ambulatory LIFT surgery were retrospectively compared with 386 cases managed as in-patients. Patient demographics, comorbidities, postoperative morbidity and pain as well as readmission rates within 30 days and satisfaction ratings were compared between the two groups. Results When compared with patients undergoing in-patient surgery, those in the ambulatory group were younger with a better level of education ( P < 0.05). Ambulatory cases returned to work after shorter postoperative periods ( P < 0.01) but experienced more frequent postoperative external hemorrhoidal thrombosis and more reported postoperative pain ( P < 0.05). There were no differences in the overall rate of complications or readmissions between the two groups. Ambulatory patients reported higher satisfaction ratings than in-patients ( P < 0.05). Conclusions The LIFT procedure for anal fistula can be safely performed in the ambulatory setting resulting in an acceptable level of satisfaction and a more rapid return to work when compared with in-patient fistula management.

Ligation of Intersphincteric Fistula Tract (LIFT) for the Treatment of Anal Fistula: A Prospective Observational Study

“…26 We also routinely use prophylactic antibiotics, although we know it is controversial. 25 Moreover, we treated all our cases in an ambulatory surgery setting, a concept which a recent retrospective study 48 also favors.…”

Siete años de experiencia en pacientes intervenidos por patología proctológica bajo modalidad cirugía mayor ambulatoria y estudio del grado de satisfacción usuaria.

“…La cirugía mayor ambulatoria es una estrategia importante para muchos procedimientos y cirugías. En cirugía proctológica realizada en nuestro hospital, bajo esta modalidad, se obtuvieron resultados clínico-quirúrgicos aceptables y acorde a lo descrito en la literatura internacional [15][16][17] , con resultados claramente diferenciables para la enfermedad pilonidal comparativamente con las demás enfermedades. Con respecto a la satisfacción usuaria, ésta fue positiva en la mayoría de las preguntas con altos porcentajes y sin una clara distinción por patologías.…”

Rectal Fistulas: Current State of the Problem

“…госпитализации оперированных пациентов в течение 30 дней после вмешательства (в 5,44% случаев) были вызваны вторичным кровотечением, замедленным заживлением раны. Эффективной процедура в данном исследовании признана у 78% пациентов [9].…”