Anal incontinence in patients with fistula-in-ano: a comparative study between LIFT (ligation of inter-sphincteric fistulous tract) and fistulectomy

Authors

  • Vijayalakshmi Vidyanendh Department of General Surgery, Kilpauk Medical College, Chennai, Tamil Nadu, India
  • Amilthan Karunakaran Department of General Surgery, Kilpauk Medical College, Chennai, Tamil Nadu, India
  • Arun Damodharan Department of General Surgery, Kilpauk Medical College, Chennai, Tamil Nadu, India
  • Venkatesh Balaiah Karuppiah Department of General Surgery, Kilpauk Medical College, Chennai, Tamil Nadu, India
  • Vaitheeswaran Madhesan Department of General Surgery, Kilpauk Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182768

Keywords:

Anal incontinence, Anal pressure, Fistula in ano, Fistulectomy, LIFT, Sphincter defect

Abstract

Background: General surgeons perform surgeries for Fistula in ano day in and day out as elective procedures. Fistula in ano is more common nowadays because of improper hygiene. 3 major basic aims of Fistula in ano surgeries are control of sepsis closure of fistula and maintenance of continence. Post operatively some patients developed anal incontinence due to sphincter injury which affects patients’ day to day activity. The present study compared the utility and effectiveness of two standard procedures LIFT (Ligation of Intersphincteric Fistula Tract) and Fistulectomy in terms of anal incontinence.

Methods: This study included 100 patients with fistula in ano during the 6 months period from January 2017 to June 2017. Randomized controlled trial was done to divide the patients into two groups. Group A underwent fistulectomy and Group B underwent LIFT (Ligaton of intersphincteric fistulous tract). Post-operative anal incontinence between the two groups were observed for 6 months.

Results: In our study it was observed that four patients of group A (fistulectomy) had anal incontinence whereas no patients in group B (LIFT) developed anal incontinence.

Conclusions: LIFT (Ligation of intersphincteric fistulous tract) is a better procedure when compared to fistulectomy in preserving sphincter function and preventing anal incontinence offering better quality of life.

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References

Rojanasakul A, Pattanaarun J, Sahakitrungruang C, TantiphlachivaK. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai 2007;90(3):581-6.

Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum. 2010;53(1):39-42.

Nirmala A, Jiva N, Swaminathan R, Sivakumar V. A comparative study on various techniques in management of fistula in ano. IOSR J Dent Med Sci. 2016;15(6):8-13.

Alapach S, Khaimook A. Comparison between ligation of intersphincteric fistula Tract (LIFT) technique and canventional fistulotomy in the reatment of fistula-in-Ano at Hat Yai regional hospital. Thai J Surg. 2014;35(1):20-3.

Sileri P, Franceschilli L, Angelucci GP, D’Ugo S, Milito G, Cadeddu F, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study. Techniq Coloproctol. 2011;15(4):413-6.

Yardimci E, Cipe G, Hasbahceci M, Aysan E, Bektasoglu H, Idiz U, Muslumanoglu M. Comparison of lift and fistulotomy in treatment of intersphincteric and low transsphincteric anal fistula: prospective randomized study. Dis Colon Rectum. 2015;58(5): E165-E165.

Meinero P, Mori L. Video-assisted Anal fistula treatment (VAAFT): A novel sphincter-saving procedure for treating complex anal fistulas. Techniq Coloproctol. 2011;15(4):417-22.

Aboulian A, Kaji AH, Kumar RR. Early result of Ligation of the Intersphincteric Fistula Tract for Fistula-in-ano. Dis Colon Rectum. 2011;54(3):289-92.

Matos D, Lunniss PJ, Phillips RK. Total sphincter conservation in high fistula in ano: results of a new approach. Br J Surgery. 1993;80(6):802-4.

Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Dis Colon Rectum. 2010;53(1):43-6.

Mushaya C, Bartlett L, Schulze B, Ho YH. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. Am J Surgery. 2012;204(3):283-9.

Ooi K, Skinner I, Croxford M, Faragher I, McLaughlin S. Managing fistula‐in‐ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience. Colorectal Dis. 2012;14(5):599-603.

Tan KK, Tan IJ, Lim FS, Koh DC, Tsang CB. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum. 2011;54(11):1368-72.

Wallin UG, Mellgren AF, Madoff RD, Goldberg SM. Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?. Dis Colon Rectum. 2012;55(11):1173-8.

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Published

2018-06-25

How to Cite

Vidyanendh, V., Karunakaran, A., Damodharan, A., Karuppiah, V. B., & Madhesan, V. (2018). Anal incontinence in patients with fistula-in-ano: a comparative study between LIFT (ligation of inter-sphincteric fistulous tract) and fistulectomy. International Surgery Journal, 5(7), 2533–2536. https://doi.org/10.18203/2349-2902.isj20182768

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Original Research Articles