Ligation of the intersphincteric fistula tract (lift) procedure; a new sphincter preserving procedure in treatment of high anorectal fistula in holy karbalaa.

Abstract

Background: Anorectal fistula is one of the most common annoying conditions that the patients suffering from, which making him seeking surgical advice. High fistula is the most risky type of anorectal fistula to be treated surgically, due to the risk of sphincter injury. Many surgical procedures are used to treat this condition, LIFT is one of the newest procedures that are used to treat high fistula in ano. Aim: In this study we evaluate the LIFT procedure as a sphincter preserving modality in treating high type fistula in ano on the base of postoperative complication including incontinence and recurrence. Method: An interventional comparative study conducted from 1st of November 2019 to 30th of October 2021 in gastroenterology medical and surgical center in AL-Hussain medical city in Karbala. Where, collect sixteen patients who presented to had high fistula in ano ( trans or supra sphincteric fistula). Result: A 16 patients with a mean age (40, 7 ± 8 years) underwent ligation of inter- sphenctric fistula tract, vast majority of patients who were suffering from pain, nearly all combined with discharge, about one quarter of them previously suffering from bleeding . and only 25% where suffer from incontinence a single case had a recurrence of his fistula after 4 weeks of surgical intervention, there was significant statistical difference between type of fistula and recurrence. A total of 14 patients underwent ligation of intersphincteric fistula, only 2 cases underwent suprasphinictric tract ligation,. 32% had two previous attempts at surgery. The mean follow up was 26 months. Successful fistula closure was achieved in nearly all patients. The time of recurrence was 4 weeks. Only one case of each procedures report transient gas incontinence. Conclusion: even-though working procedure is relatively difficult to perform, but ended with a high healing rate and appears to be safe with low morbidity and no impact on continence. The results without or with partial fistulectomy procedures are similar.