Ligation of the intersphincteric fistula tract in low transsphincteric fistulae: a new technique to avoid fistulotomy

Abstract

Low transsphincteric fistulae can be treated successfully by LIFT, without affecting faecal continence. Division of the lower part of the external anal sphincter is no longer necessary in the treatment of low transsphincteric fistulae, which is essential for patients with compromised anal sphincters.

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

“…One only compared LIFT with a modification of LIFT, rather than a standard treatment, whilst the other two compared LIFT with a mucosal advancement flap. In addition, 18 case series have been reviewed [187,[190][191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206] (Table 3). A number of series reporting fewer than 10 patients were disregarded for the purposes of this position statement.…”

Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review

“…Twelve of the 13 studies reported postoperative continence. However, only seven evaluated patients pre-and postoperatively using a validated incontinence score [16,20,[23][24][25][26][27]. In total 183 patients were formally assessed, of whom 11 (6%) had a minor functional disturbance.…”

Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review

“…The failure rate is approximately 30-60 % for established surgical procedures such as the endorectal advancement flap (ERAF) [3,4] and injection of biological glues [5,6]. Also the initial enthusiasm for even newer techniques, such as anal fistula plug [7,8] and ligation of the intersphincteric fistula tract (LIFT) [9,10], decreased at the long-term follow-up, with a recurrence rate of about 70-80 % and 30-60 %, respectively [11][12][13][14][15].…”