title: Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula-in-ano.
abstract: BACKGROUND
  Ligation of intersphincteric fistula tract is a novel surgical technique in the treatment of transsphincteric fistula-in-ano that has been shown to be successful in the short term. Median follow-up in current literature ranges from 5 to 9 months. However, the long-term success rate is unknown.
  
  
  OBJECTIVE
  This study describes our long-term results in performing the ligation of intersphincteric fistula tract procedure.
  
  
  METHODS
  This study is a retrospective review.
  
  
  METHODS
  Thirty-eight patients from August 2008 to October 2011 were evaluated.
  
  
  METHODS
  All patients underwent the ligation of intersphincteric fistula tract for fistula-in-ano.
  
  
  METHODS
  Patient and fistula characteristics, primary healing rate, secondary healing rate, previous treatments, and failures were reviewed.
  
  
  RESULTS
  The median follow-up was 26 months (range, 3-44 months), and 26 patients (68%) were followed for greater than 12 months. The overall primary healing rate was 61% (23 of 38), and it was 62% (16 of 26) in patients followed for over 12 months. Eighty percent (12/15) of the failures are early failures (persistent symptoms or failure at ≤6 months), and 20% are late failures (>6 months) with 1 failure occurring 12 months postprocedure. Increase in length of fistula tract was associated with decreased healing (OR 0.55, 95% CI 0.34-0.88, p = 0.01). There were no intraoperative complications and no reported incontinence.
  
  
  CONCLUSIONS
  Our study demonstrates favorable long-term results for the ligation of intersphincteric fistula tract procedure. It appears that long tracts negatively affect healing, and late failures can occur up to 12 months postoperatively. Understanding the type of failure can help guide subsequent treatment to maximize healing success.
authors: Harbor-UCLA Medical Center, Division of Colon and Rectal Surgery, Torrance, CA 90502, USA.
authors: Wendy Y
authors: WY
authors: Liu
authors: Armen
authors: A
authors: Aboulian
authors: Amy H
authors: AH
authors: Kaji
authors: Ravin R
authors: RR
authors: Kumar
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000601:surgery*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014945:Wound Healing