Ligation of the Intersphincteric Fistula Tract As an Emergency Treatment for Cryptoglandular Anal Fistula

Overview

Journal Malays J Med Sci

Specialty General Medicine

Date 2024 Mar 8

PMID 38456116

Authors

Diana Melissa Dualim

Michael Pak-Kai Wong

Siti Mayuha Rusli

Abdel Latif Khalifa Elnaim Ali

Ismail Sagap

Affiliations

Soon will be listed here.

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% ( 10), with a median healing time of 2 months (range 0.5-4). For the EL-LIFT group, the healing rate was 100% ( 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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