ORIGINAL ARTICLES   

Chirurgia 2013 August;26(4):287-90

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Treatment of fistula-in-ano by lift procedure: a preliminary report

Gentile M., De Rosa M., Cestaro G., Mosella F., Amato B.

Department of General Surgery, “Federico II” University of Naples, Naples, Italy

Aim: LIFT procedure is the most recent attempt in closure of trans-sphincteric fistula tracts. Data suggest that the risk of impaired continence following division of the lower third of the external anal sphincter is not insignificant, especially in female patients with an anterior fistula and patients with diminished anal sphincter function Literature data are poor. In this study, we present our initial experience with this technique.
Methods: 15 patients with transphincteric fistulas were enrolled. All patients were studied by clinical examination and proctoscopy. The primary end-point measured was cure of the disease. The secondary end-point was the degree of postoperative continence. Surgical procedures were performed as Day-case surgery and patients operated under loco-regional anesthesia: patients were discharged on the same day of the procedure. Patients under general anesthesia were discharged on the following day. All patients were examined after a week, one month and six months from the procedure. The minimum follow-up for all patients was six months (range 6-18 months)
Results: As results of the procedure eleven patients (73.3%) had a primary healing. Three patients (20%) had a recurrence observed between 5 and 25 weeks after the operation. One patient with a previous semihorseshoe fistula (6.6%) showed a recurrence as intersphincteric fistula (confirmed by endoanal ultrasound) and was successfully treated by lay-open operation.
Conclusion: LIFT procedure showed, in our experience, good results although in a selected group of patients with transphincteric fistulas A long-term follow-up is needed to validate these results such as a less selected group of patients to treat