What happens after a failed LIFT for anal fistula?

Wright, Moriah; Thorson, Alan G.; Blatchford, Garnet J.; Shashidharan, Maniamparampil; Beaty, Jennifer; Bertelson, Noelle L.; Aggrawal, Piyush; Taylor, Lindsay; Ternent, Charles A.

doi:10.1016/j.amjsurg.2017.08.042

Cited by 15 publications

(14 citation statements)

References 36 publications

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“…106–110 Endorectal advancement flap repeated after a failed flap procedure or performed after other failed initial approaches including LIFT is associated with healing rates ranging between 57% and 100%. 106,111,112…”

Section: Methodsmentioning

confidence: 99%

“…Other studies evaluating long-term LIFT outcomes have demonstrated lower rates of primary healing, ranging from 42% to 62% 122–128 ; however, the LIFT procedure has been associated with significant rates of secondary healing after surgical reintervention (typically fistulotomy for an intersphincteric recurrence) ranging from 77% to 86%. 112,129,130…”

Section: Methodsmentioning

confidence: 99%

“…Other studies evaluating long-term LIFT outcomes have demonstrated lower rates of primary healing, ranging from 42% to 62% [122][123][124][125][126][127][128] ; however, the LIFT procedure has been associated with significant rates of secondary healing after surgical reintervention (typically fistulotomy for an intersphincteric recurrence) ranging from 77% to 86%. 112,129,130 Modifications of the LIFT procedure, including excising the lateral aspect of the tract, incorporating a fistula plug or biologic mesh interposition, or using videoassisted techniques, have been described and, in some studies, are associated with improved healing rates compared to the standard LIFT. However, the evidence evaluating these techniques is limited to small studies and such modifications to the standard LIFT technique are typically not recommended.…”

Section: Transsphincteric Fistulas May Be Treated With Ligationmentioning

confidence: 99%

See 2 more Smart Citations

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

Gaertner

Burgess

Davids

et al. 2022

Diseases of the Colon &Amp; Rectum

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Transsphincteric Fistulas May Be Treated With Ligationmentioning

confidence: 99%

See 1 more Smart Citation

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

Gaertner

Burgess

Davids

et al. 2022

Diseases of the Colon &Amp; Rectum

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“…No significant difference was found whether the fistula was anteriorly, posteriorly or laterally located relative to the length, width or depth of the MRI-measured tract (Table 1, n = 22). A fistula tract length measuring >3 cm intraoperatively had an adverse effect on healing at 4 months [14,15] while McGee and colleagues showed that fistula length >4 cm predicts improved healing with anal fistula plugs [14,16].…”

Section: Discussionmentioning

confidence: 99%

High failure rates following ligation of the intersphincteric fistula tract for transsphincteric anal fistulas: are preoperative MRI measurements of the fistula tract predictive of outcome?

et al. 2020

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Aim: Treatment of transsphincteric fistulas (TSFs) with fistulotomy after an indwelling seton is tempered by risks of incontinence and litigation. Thus, ligation of the TSF tract has been popularized as an alternative option. We previously reported on 107 patients who underwent ligation of the intersphincteric fistula tract (LIFT), with a 46% failure rate.Posterior fistula was the only predictor of recurrence. The aim of the present work was to investigate whether the length, width or depth of the fistula measured on preoperative MRI was correlated with recurrence.Method: Following institutional review board approval, a retrospective analysis of our prospective Complex Anal Fistula Database from 1 January 2011 to 31 August 2019 was performed. Patients with TSF who underwent preoperative MRI and LIFT were included.Fistula location was classified as anterior, posterior or lateral. MRI measurements of fistula length, width and depth (in the intersphincteric groove) were performed. The type and rate of postoperative recurrence were analysed.Results: 173 patients underwent MRI for an anal fistula; of these 40 underwent LIFT and 22/40 (55%) had preoperative MRI. There was no difference in the length, width or depth of anterior (n = 9), posterior (n = 7) or lateral (n = 6) fistula tracts. The overall recurrence rate was 9/22 (41%). Posterior TSFs had the highest recurrence rate (5/7, 71%). Conclusion:The mean length, width, and depth of the fistula tract, measured at the preoperative site of LIFT in the intersphincteric groove, did not correlate with recurrence regardless of fistula location.

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“…Схожий процент успешных результатов после установки «свободного сетон» выявлен у больных, которым в качестве второго этапа хирургического лечения выполнена перевязка свищевого хода в межсфинктерном пространстве. Он колеб лется в пределах от 37 до 92 %, без статистически значимых различий результатов с пациентами без дренирования [29][30][31][32][33][34][35]. Это подтверждено проведенным K. D. Hong et al (2013) [36] системным метаанализом (RR = 0,96; CI 95 % 0,8-1,16; (P = 0,69) и недавним метаанализом А. И. Мусина, И. В. Костарева (2018) [37], хотя анализированные работы имели разный дизайн и гетерогенность, что не может в полной мере вносить ясность в применение методики.…”

Section: ус т а н о в к а л и г а т у р ы ( L O O S E S E T O N ) п еunclassified

Ligature method for the treatment of anal fistula: a modern view on the old approach (literature review)

Musin

Антипова

Ульянов³

et al. 2019

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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Despite a thousand-year history of anal fistula treatment, long-term outcomes have not been optimal, which encourages us to explore new surgical approaches. One of the methods of surgical treatment of anal fistulas is the use of ligature (Seton) in its different modifications. This review analyzes the literature data on the use of different modifications of seton treatment of anal fistulas. The analysis of publications showed the great interest in the use of the method, yet there is neither clear scheme nor systematic approach to applying it in clinical practice. Further study, as well as randomized researches, are required to find the optimal treatment and improve surgery results of using seton when dealing with anal fistula.

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What happens after a failed LIFT for anal fistula?

Cited by 15 publications

References 36 publications

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

High failure rates following ligation of the intersphincteric fistula tract for transsphincteric anal fistulas: are preoperative MRI measurements of the fistula tract predictive of outcome?

Ligature method for the treatment of anal fistula: a modern view on the old approach (literature review)

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