title: Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study.
abstract: BACKGROUND
  Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique.
  
  
  METHODS
  Between October 2010 and April 2011, 18 patients with 'complex' fistulas underwent LIFT. All patients were enrolled in the study after a physical examination including digital examination and proctoscopy. For the purpose of this pilot study, fistulas were classified as complex if any of the following conditions were present: tract crossing more than 30% of the external sphincter, anterior fistula in a woman, recurrent fistula or pre-existing incontinence. Endpoints were healing time, presence of recurrence, faecal incontinence and surgical complications.
  
  
  RESULTS
  Ten patients were men and 8 were women; mean age was 39 years; minimum follow-up was 4 months. Three patients required drainage seton insertion and delayed LIFT. After LIFT, 1 patient experienced haemorrhoidal thrombosis. At the end of the follow-up, 15 patients (83%) healed with no recurrence. Three patients had persistent symptoms and required further surgical treatment. We did not observe postoperative worsening of continence.
  
  
  CONCLUSIONS
  Results from our pilot study indicate that this novel sphincter-saving approach is effective and safe for treating complex anal fistula.
authors.affiliation: Department of Surgery, University of Rome Tor Vergata, Policlinico Tor Vergata, Chirurgia Generale (6B), Viale Oxford 81, 00133 Rome, Italy. piersileri@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Sileri
authors.forename: L
authors.initials: L
authors.lastname: Franceschilli
authors.forename: G P
authors.initials: GP
authors.lastname: Angelucci
authors.forename: S
authors.initials: S
authors.lastname: D'Ugo
authors.forename: G
authors.initials: G
authors.lastname: Milito
authors.forename: F
authors.initials: F
authors.lastname: Cadeddu
authors.forename: I
authors.initials: I
authors.lastname: Selvaggio
authors.forename: S
authors.initials: S
authors.lastname: Lazzaro
authors.forename: A L
authors.initials: AL
authors.lastname: Gaspari
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011351:Proctoscopy; D011446:Prospective Studies; D012003:Rectal Fistula / Q000175:diagnosis / Q000601:surgery*; D055502:Secondary Prevention; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
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