Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract

Khadia, Mohanlal; Muduli, Iswar Chandra; Das, Sushanta K.; Mallick, Sworupa Nanda; Bag, L.; Pati, Manas Ranjan

doi:10.4103/1117-6806.169818

Cited by 22 publications

(22 citation statements)

References 17 publications

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“…No patient reported any subjective decrease incontinence after the procedure. 14 Jain et al in their study observed no incontinence or recurrence in follow up period of 12 weeks. 4 Our study is consistent with the study by Jain et al with similar results.…”

Section: Discussionmentioning

confidence: 81%

Untitled

2019

MIJOSUR

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Background:The treatment of anal fistula is mainly surgical to eliminate the fistula prevent recurrence and preserve anal continence. LIFT (Ligation of intersphincteric fistula track) is an advanced technique for saving the anal sphincter during fistulectomy. Aim: To compare postoperative complications of fistula in Ano managed with open fistulectomy and LIFT method. Material and Methods: A total of 60 patients of fistulainAno with single internal opening were included in the study. 30 cases were treated by LIFT technique and 30 cases were treated by fistulectomy. Outcome of the patient was measured in terms of pain (VAS Score), hospital stay, incontinence, wound infection and recurrence. Results: There was less pain in post-operative period which was significantly lower than fistulectomy at post-operative day 3 (P<0.0001) and at day of discharge (P=0.035). Hospital stay was significant less for LIFT group of patients than fistulectomy (P=0.008). No incontinence in case of LIFT group than conventional fistulectomy where one case had incontinence. Complications like postoperative infection were found in 2 cases in both groups, which was statistically not significant. Conclusion: The LIFT method of fistula in Ano is more beneficial in cases of low lying transphincteric group of tracts with single internal and external opening in terms of hospital stay pain and operative time required

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Section: Discussionmentioning

confidence: 81%

Untitled

2019

MIJOSUR

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“…16 Also in current study, perineum discharge was the commonest symptom in all cases (100%) and which was either continuous or intermittent in nature as similar to the previous studies. 1,[17][18][19][20][21] Almost all cases had one opening either on one side of midline to right or left and anterior or posterior to the anal opening. Only two cases had 2 openings each in this present series.…”

Section: Resultsmentioning

confidence: 99%

Clinical study of fistula in ano with special reference to its surgical management

Ghose

Chowdhury²,

Dharmamer³

2020

Int Surg J

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Background: The present study was undertaken to evaluate the results of “Lay open method” fistulectomy technique in treating fistula-in-ano in terms of relief of symptoms, healing of wound, recurrence rate and post-operative complications.Methods: Total 45 cases with definite history of fistula and clinically diagnosed cases of fistula in ano selected for the study. A final diagnosis was made after proctoscopic examination under anaesthesia during operation and by histopathological examination after completion of operation. In all the patients, lay open method fistulectomy was done. Post-operative period was closely monitored and all the cases were meticulously followed for a variable period of time.Results: The common fistulas were low anal type (80%). External opening was mostly located in the posterior mid zone (44.44%). Internal opening was found in 30 cases (66.66%) during per rectal digital examination while proctoscopic examination revealed internal opening in 26 cases (57.77%). Pain (22.22%), retention of urine (8.88%) were the commonest immediate as well as incontinence (1; 2.22%) and recurrence (1; 2.22%) were the delayed post-operative complications. 90% of cases had a satisfactory healing of their wounds within 21 days. Excellent results were achieved in 77.77% cases and only one case of recurrence (2.22%).Conclusions: Encouragingly high success rates were achieved in our patients, but this series comprised a very small number of patients in a short period of time with limited amenities; also follow up of very short duration and irregular for which a definite conclusion is difficult to arrive at.

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“…Khadia M et al; conducted a prospective study which aimed to LIFT in the management of patients of fistula-in-ano of cryptoglandular origin in 52 patients managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. 6 A total of 52 patients were studied. Median follow-up was 24 weeks.…”

Section: Discussionmentioning

confidence: 99%

Fistula in ano: open method compared to lift method ligation of intersphincteric fistula track

Potula

2017

Int Surg J

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Background: To compare fistula in ano open method with lift method ligation of intersphincteric fistula track.Methods: This is a prospective study which consisted of 70 patients suffering from fistula-in-ano who were admitted to surgery department. All patients above 18 years of age, cases of transsphincteric low anal fistula, maturation of tract were included in the study. Results: In this study, 60 patients were included totally, of which, 10 patients were excluded as 5 patients had tuberculosis, 2 had Crohn's disease and 3 were excluded as they lost follow up. Hence, 50 patients were included in the study. 40 were males and 10 were females with a male to female ratio of 4:1 in this study. The average age of fistula in ano was 45.34±10.39 years. The incidence of fistula in ano was maximum in the age group of 46-55 years. The minimum incidence was in the age < 30 years. The most common primary fistula is intersphincteric track (46%), followed by transsphincteric track (42%). The most common type of fistula in ano patients was discharge from the tract which was in all patients, in others, perianal pain and bleeding was observed. Fistula in ano can be divided into low and high level of fistula. High level of fistula-in-ano was found in 64 % of patients and low level of fistula-in-ano was found in 36% of patients. Recurrence was seen in 6 patients with high suprasphincteric track who were ligated below the internal opening and 10 patients had a recurrence with transsphincteric track of which 6 were obese which made identifying the fistula track difficult. Conclusions: The LIFT procedure is advantageous as no chance of incontinence prevails as the infective focus is removed without dividing any part of sphincter complex, other advantages are that it is easy to learn, perform, safe, high healing rate, low morbidity and easily treat fistula in ano at primary health care level.

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Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract

Cited by 22 publications

References 17 publications

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Clinical study of fistula in ano with special reference to its surgical management

Fistula in ano: open method compared to lift method ligation of intersphincteric fistula track

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