Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract (LIFT)
- 27 July 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in Techniques in Coloproctology
- Vol. 18 (1), 13-22
- https://doi.org/10.1007/s10151-013-1050-7
Abstract
Anal fistula management has long been a challenge for surgeons. Presently, no technique exists that is ideal for treating all types of anal fistula, whether simple or complex. A higher incidence of poor sphincter function and recurrence after surgery has encouraged the development of a new sphincter-sparing procedure, ligation of the intersphincteric fistula tract (LIFT), first described by Van der Hagen et al. in 2006. We assessed the safety, feasibility, success rate, and continence of LIFT as a sphincter-saving procedure. A literature search of articles in electronic databases published from January 2006 to August 2012 was performed. Analysis followed Preferred Reporting Items for Systematic Reviews recommendations. All LIFT-related articles published in the English language were included. We excluded case reports, abstracts, letters, non-English language articles, and comments. The procedure was described in detail as reported by Rojanasakul. Thirteen original studies, including 435 patients, were reviewed. The most common fistula procedure type was transsphincteric (92.64 %). The overall median operative time was 39 (±20.16) min. Eight authors performed LIFT as a same-day surgery, whereas the others admitted patients to the hospital, with an overall median stay of 1.25 days (range 1–5 days). Postoperative complications occurred in 1.88 % of patients. All patients remained continent postoperatively. The overall mean length of follow-up was 33.92 (±17.0) weeks. The overall mean healing rate was 81.37 (±16.35) % with an overall mean healing period of 8.15 (±5.96) weeks. Fistula recurrence occurred in 7.58 % of patients. LIFT represents a new, easy-to-learn, and inexpensive sphincter-sparing procedure that provides reasonable results. LIFT is safe and feasible, with favorable short- and long-term outcomes. However, additional prospective randomized studies are required to confirm these findings.Keywords
This publication has 35 references indexed in Scilit:
- Managing fistula‐in‐ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experienceColorectal Disease, 2012
- Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational studyTechniques in Coloproctology, 2011
- Obesity is a negative predictor of success after surgery for complex anal fistulaBMC Gastroenterology, 2011
- Current management of cryptoglandular fistula-in-anoWorld Journal of Gastroenterology, 2011
- Idiopathic fistula-in-anoWorld Journal of Gastroenterology, 2011
- LIFT procedure: a simplified technique for fistula-in-anoTechniques in Coloproctology, 2009
- Treatment of Complex Anal Fistulas with the Collagen Fistula PlugDiseases of the Colon & Rectum, 2008
- Surgical management of anal fistulae: a systematic reviewColorectal Disease, 2008
- Endorectal flap advancement repair and fistulectomy for high trans-sphincteric and suprasphincteric fistulasBritish Journal of Surgery, 2000
- Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal/vaginal fistulasDiseases of the Colon & Rectum, 1996