title: Ligation of intersphincteric fistula tract and its modification: Results from treatment of complex fistula.
abstract: OBJECTIVE
  To compare healing rates between intersphincteric fistula tract (LIFT) and LIFT plus partial fistulectomy procedures.
  
  
  METHODS
  A study of complex fistula-in-ano patients was carried out from 1(st) March 2010 to 31(th) January 2012. All operations were done by colorectal surgeons at a referral center in a Ministry of Public Health hospital. Data collected included patients' demographic details, fistula type determined by endorectal-ultrasonography, preoperative and postoperative continence status, previous operations, time between diagnosis of fistula-in-ano and operation, type of surgery, healing rates, recurrence rates, and types of failure examined by endorectal-ultrasosnography, re-operation in recurrence or failure cases, and complications.
  
  
  RESULTS
  The study involved 41 patients whose average age was 40.78 ± 11.84 years (range: 21-71 years). The major fistula type was high-transsphincteric type fistula. The median follow-up period was 24 wk. The overall success rate was 83%: in the LIFT (Ligation intersphincteric fistula tract) group the success rate was 81% and in the LIFT plus (LIFT with partial coreout fistulectomy) group it was 85% (P = 0.529). The median wound-healing time was 4 wk in both groups (P = 0.262). The median time to recurrence was 12 wk. Neither group had incontinence (Wexner incontinence score-0) and the difference in healing rates between the two groups was not statistically significant.
  
  
  CONCLUSIONS
  There was no difference in results between LIFT and LIFT plus operations. The LIFT procedure is a good option for maintaining continence in management of fistula-in-ano.
authors.affiliation: Siripong Sirikurnpiboon, Burin Awapittaya, Paiboon Jivapaisarnpong, Colorectal Division, General Surgery Department, Rajavithi Hospital, Rangsit University, Bangkok 10400, Thailand.
authors.forename: Siripong
authors.initials: S
authors.lastname: Sirikurnpiboon
authors.forename: Burin
authors.initials: B
authors.lastname: Awapittaya
authors.forename: Paiboon
authors.initials: P
authors.lastname: Jivapaisarnpong
keywords: Complex fistula; Fistula-in-ano; Incontinence; Intersphincteric fistula tract; Perianal disease