Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano | ||||
| SVU-International Journal of Medical Sciences | ||||
| Article 45, Volume 7, Issue 2, July 2024, Page 491-500 PDF (384.52 K) | ||||
| Document Type: Original research articles | ||||
| DOI: 10.21608/svuijm.2024.313168.1966 | ||||
 View on SCiNiTO | ||||
| Author | ||||
Ayman Helmy Ibrahim  
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| Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Treatment of trans-sphincteric fistulas with fistulectomy involves a large wound with risk of incontinence and recurrence. Procedure of Ligation of Inter-sphincteric Fistula Tract (LIFT) approach emerged recently and expected to provide more favorable outcomes and less risk of incontinence. Objectives: This comparative study was done to evaluate operative and postoperative outcomes of LIFT procedure in comparison with traditional fistulectomy in treatment of trans-sphincteric fistulas. Patients and methods: Study was carried out on 48 patients with trans-sphincteric fistulas assigned into 2 groups; group A treated with LIFT included 23 patients and group B treated with fistulectomy done in 25 patients. Results: Mean operative time was significantly shorter in group A than in group B (p = 0.001). Postoperative pain means sores were significantly less in LIFT group; than in groups A and B respectively (p = 0.04), while hospital stay showed no statistical significance; in group A versus in group B (p= 0.25). The mean wound healing in LIFT group was significantly shorter than in fistulectomy group (p = 0.003). As regard postoperative complications in groups A and B, infection reported in 4 & 7 patients (17.3% & 28%), minor bleeding in 2 & 4 patients (8.6% & 16 %) respectively, no incontinence reported in group A and 3 patients shown temporary incontinence to flatus in group B. Overall recurrence was 31.2 % (15 patients); 6 patients (26.1 %) post-LIFT and 9 patients (36 %) post-fistulectomy includes failure of healing (3 post-LIFT and 5 post-fistulectomy), difference in recurrence was insignificant (p = 0.3). Conclusion: LIFT procedure offers a shorter operative time, lower postoperative pain, faster wound healing and low incidence of incontinence in comparison to fistulectomy while recurrence rate was insignificantly different. | ||||
| Keywords | ||||
| Ligation; Trans-Sphincteric Fistula Tract; Fistulectomy; Ano; Granulomatous | ||||
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