1. Table 2: Published case series of VTE after colorectal surgery.
Ligation of intersphincteric fistula tract (LIFT) for fistula in ano: lessons learned from a decade of experience.
S Malakorn, T Sammour, S Khomvilai, I Chowchankit, S Gunarasa, P Kanjanasilp, C Thiptanakij, A Rojanasakul
Introduction
Ligation of intersphincteric fistula tract (LIFT) is a well described sphincter preserving technique for the management of fistula in ano. This study aims to report a 10 year experience of LIFT with extended long term follow-up.
Methods
Retrospective analysis of single center data from May 2006 to October 2010 was performed. All patients with primary or recurrent FIA who underwent LIFT procedure were included. Patients with malignancy, incontinent patients, and patients with rectovaginal fistula were excluded.
Healing as defined by the absence of symptoms with no visible external opening on clinical examination.
Follow-up was continued until May 2016.
Type of fistula
Number
Healing(%)
Intersphincteric 27
23 (85.0)
Trans-sphincteric
Straight tract
Low trans-sphincteric
High trans-sphincteric
Curve tract
Unilateral (Semi-horseshoe ischioanal)
Bilateral (Horseshoe ischioanal)
140 15 64 5
129 (92.0)
9 (60.0)
57 (89.0)
2 (40.0)
Previous non-LIFT fistula surgery 42
38 (90.5)
Overall healing after first procedure
251
220 (87.7)
Results
251 patients were identified, with a primary healing rate of 87.7% at a median follow-up of 71 months. Of the 42 patients who had unhealed fistula after previous non-LIFT surgery, 38 (90.5%) healed after first attempt at LIFT. There were 31 unhealed fistula patients after the first LIFT. Of these, 3 spontaneously healed, and the rest underwent either repeat LIFT, fistulotomy (if the recurrence was intersphincteric), or simple curettage (if no internal opening was found).
Ultimately, only 2 out of the original 251 patients remained unhealed, and there was no change in subjective continence status after surgery.
Conclusion
LIFT is an effective technique for the treatment of fistula in ano, including recurrent or unhealed fistula after other procedures.
Table 2: Published case series of VTE after colorectal surgery.