THE EXPERIENCE OF LIGATION OF INTERSPHINCTERICFISTULA TRACT IN THE TREATMENT OF PATIENTS WITH TRANS- AND SUPRASPHINCTERIC ANAL FISTULAE

Abstract

AIM. Ligation of intersphinctericfistllа tract (LIFT) is a new sphincter-preserving technique avoiding development of anal incontinence. The aim of the study is evaluation of effectiveness of this procedure. METHOD. From Jan 2013 to Dec 2015 40 patients with anal fistulae, exciting more than 30% of anal sphincter was included in the study. Male: 28 (70%), Female: 12 (30%). 29 (72,5%) cases were middle transsphincteric, 16 (22,5%) - deep transsphincteric and 2 (5%) was suprasphincteric. RESULTS. The median follow up was 16 months ((3-36) months). The healing rate was (72,5%). Recurrents developed in 5 (17,3%) patients with middle transsphincteric fistulae, 5 (55,6%) - with deep transsphincteric fistulae, and 1 (50%) with suprasphincteric fistulae. 4 patients developed an intersphincteric abscess. After excision of this fistulae healing occurred in all four cases. A second operation did not affect the function of anal continence. At follow-up there was no change in continence evaluated by Wexner score and anorectal manometry. CONCLUSION. LIFT has a high success rate in middle transsphinteric anal fistulae. Recurrence is related to deep portion fistulae or suprasphinteric fistula tract.