Dualim DM, Wong MPK, Rusli SM, Elnaim Ali ALK, Sagap I. Ligation of the Intersphincteric Fistula Tract as an Emergency Treatment for Cryptoglandular Anal Fistula.
Malays J Med Sci 2024;
31:62-70. [PMID:
38456116 PMCID:
PMC10917591 DOI:
10.21315/mjms2024.31.1.5]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 04/06/2023] [Indexed: 03/09/2024] Open
Abstract
Introduction
Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treating anal fistula of cryptoglandular origin. Our prospective study aimed to determine the postoperative outcomes of patients undergoing LIFT in emergency and elective settings.
Methods
This was a single-centre prospective observational study of the LIFT procedure for the treatment of anal fistulas. The differences in the 6-month postoperative outcomes between the emergency and elective procedures were analysed, including the healing rate, healing time, recurrence rate, recurrence time, postoperative complications and length of hospital stay.
Results
Twenty-two patients were recruited for this study: 11 patients underwent LIFT as an emergency procedure (EM-LIFT), while the others underwent LIFT as an elective procedure (EL-LIFT). The healing rate for the EM-LIFT group was 90.9% (n = 10), with a median healing time of 2 months (range 0.5-4). For the EL-LIFT group, the healing rate was 100% (n = 11), with the same median healing time of 2 months (range 0.5-4). Two of the patients in the EM-LIFT group developed recurrence, with a median recurrence time of 5 months (range 4-6) and three developed recurrence in the EL-LIFT group, with the same median recurrence time of 5 months (range 4-6). There were minor postoperative complications of pain and subcutaneous infection, with no faecal incontinence. There was no statistically significant difference in postoperative outcomes between the groups.
Conclusion
EM-LIFT is a feasible and safe primary procedure for active cryptoglandular-type anal fistulas.
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