Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano.
OBJECTIVE
Ligation of the intersphincteric fistula tract and reinforcement with a bioprosthetic graft are two recently reported procedures that have shown promise in the treatment of anal fistula. This study was undertaken to validate combining ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug and report our preliminary results and experience.


METHODS
Twenty-one patients with transsphincteric anal fistula were treated with ligation of the intersphincteric fistula tract plus concurrent bioprosthetic plug of the anal fistula. We evaluated healing time, fistula closure rate and postoperative anal function according to the Wexner continence score.


RESULTS
No mortality or major complications were observed. Median operative time was 20 (range 15-40) min. After a median follow-up of 14 (range 12-15) months, the overall success rate was 95% (20/21), with a median healing time of 2 (range 2-3) weeks for external anal fistula opening and 4 (range 3-7) weeks for intersphincteric groove incision. Only 1 (5%) patient reported rare incontinence for gas postoperatively (Wexner score 1).


CONCLUSIONS
Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug is an easy, safe, effective and useful alternative in the management of anal fistula. Further randomized controlled studies are necessary to better evaluate long-term results.
Department of General Surgery, Capital Medical University, Beijing, China.
J G
JG
Han
B Q
BQ
Yi
Z J
ZJ
Wang
Y
Y
Zheng
J J
JJ
Cui
X Q
XQ
Yu
B C
BC
Zhao
X Q
XQ
Yang
D062088:Acellular Dermis / Q000009:adverse effects; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects; D017577:Cutaneous Fistula / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000009:adverse effects; D012003:Rectal Fistula / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing