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Category: Volume 11 Issue 09 September 2023
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Title: Observational Study of Effectiveness of Ligation of Intersphinsteric Fistula Tract (Lift) in Perianal Fistulas Operated at AIIMS Patna

Authors: Dr Md Afsar Alam, Dr Manoj Kumar, Dr Manoj Kumar, Dr Md Hamza

 DOI: https://dx.doi.org/10.18535/jmscr/v11i9.04

Abstract

Background: Perianal fistula or fistula-in-ano, is a chronic abnormal communication, usually lined by granulation tissue, which runs outwards from the anorectal lumen (the internalopening) to an external opening on the skin of the perineum and gluteal region. Perianal fistula develops as a result of anorectal sepsis. Ligation of intersphincteric fistula tract (LIFT) is a new sphincter saving method with good result in the management of fistula. The aim of study was to evaluate the effectiveness and functional outcomes of the LIFT patients operated at AIIMS Patna.

Methods: This prospective study includes 20 patients who were operated for perianal fistulas at AIIMS Patna during the period of October 2018 to September 2019. Patients of all ages with or without history of recurrence are included. Patients with fistulas due to crohn`s disease, anal cancer and tuberculosis were excluded. A performa with detailed history, clinical presentation, per rectal examination and supportive imaging studies with pre and post operative status were done for all cases.

Results:  In this study most of the patients were male and few of them are recurrent fistula with perianal discharge. All the 20 patients with perianal fistula underwent Ligation of intersphinsteric fistula tract (LIFT). Patients were followed for a period of 3 months. Most of the cases healed completely within 2-4 weeks (90%), few cases took 6 weeks for healing (10%). Recurrence of fistula occurs in 5 cases (20%). In recurrent fistula re-recurrence occurs in 2 cases (40%).

Conclusions: The LIFT procedure is highly safe and effective means of treatment for perianal fistula with no risk of incontinence, less postoperative pain score and also better for recurrent fistulas.

Keywords: Perianal fistula, Anorectal sepsis, LIFT, Recurrence.

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Corresponding Author

Dr Md Afsar Alam

Senior Resident, Department of General Surgery