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Long-term Results of Ligation of Intersphincteric Fistula Tract (LIFT) for Fistula-in-Ano.
MedLine Citation:
PMID:  23392149     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Ligation of intersphincteric fistula tract is a novel surgical technique in the treatment of transsphincteric fistula-in-ano that has been shown to be successful in the short term. Median follow-up in current literature ranges from 5 to 9 months. However, the long-term success rate is unknown.
OBJECTIVE: : This study describes our long-term results in performing the ligation of intersphincteric fistula tract procedure.
DESIGN: : This study is a retrospective review.
PATIENTS: : Thirty-eight patients from August 2008 to October 2011 were evaluated.
INTERVENTIONS: : All patients underwent the ligation of intersphincteric fistula tract for fistula-in-ano.
MAIN OUTCOME MEASURES: : Patient and fistula characteristics, primary healing rate, secondary healing rate, previous treatments, and failures were reviewed.
RESULTS: : The median follow-up was 26 months (range, 3-44 months), and 26 patients (68%) were followed for greater than 12 months. The overall primary healing rate was 61% (23 of 38), and it was 62% (16 of 26) in patients followed for over 12 months. Eighty percent (12/15) of the failures are early failures (persistent symptoms or failure at ≤6 months), and 20% are late failures (>6 months) with 1 failure occurring 12 months postprocedure. Increase in length of fistula tract was associated with decreased healing (OR 0.55, 95% CI 0.34-0.88, p = 0.01). There were no intraoperative complications and no reported incontinence.
CONCLUSION: : Our study demonstrates favorable long-term results for the ligation of intersphincteric fistula tract procedure. It appears that long tracts negatively affect healing, and late failures can occur up to 12 months postoperatively. Understanding the type of failure can help guide subsequent treatment to maximize healing success.
Authors:
Wendy Y Liu; Armen Aboulian; Amy H Kaji; Ravin R Kumar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  56     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Affiliation:
1 Harbor-UCLA Medical Center, Division of Colon and Rectal Surgery, Torrance, California 2 Cleveland Clinic Foundation, Department of Colorectal Surgery, Cleveland, Ohio.
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