Perianal fistulas are a relatively common condition in Proctology offices, ranging from simple cases with easily palpable superficial tracts to complex problems with deep tracts across significant portions of the anal sphincter, which section can lead to varying degrees of incontinence during a fistulotomy.
Objective:
To evaluate the effectiveness of the use of the LIFT (ligation of the intersphincteric fistula tract) technique in patients with perianal transsphincteric fistulas.
Method:
A prospective study of patients with perianal transsphincteric fistula who underwent LIFT. Patients with perianal fistulas of cryptoglandular transsphincteric origin with no previous surgical interventions were included in the study. Patients with perianal fistulas from another source, such as Crohn's disease, tuberculosis, anal cancer and recurrent fistulas, were excluded. All patients underwent the same anesthetic technique, with subsequent surgical treatment in two stages: seton placement and, after 6 weeks, completion of LIFT.
Results:
We evaluated 22 patients; the mean age was 45.6 years. The post-LIFT outpatient follow-up ranged from 4 to 24 months with a mean follow-up of 14 months. The healing time varied from 4 to 8 weeks after the procedure. Seventeen patients were cured (77%) and five relapsed (23%); however, all of them exhibited the intersphincteric type, having been treated by fistulotomy and also achieving complete cure. One female patient developed mild fecal incontinence.
Conclusion:
The LIFT technique proved to be safe and effective in the treatment of transsphincteric perianal fistulas.
Fistula; Treatment; Colorectal surgery
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