title: Effective and long-term outcome following ligation of the intersphincteric fistula tract (LIFT) for transsphincteric fistula.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy and long-term outcome of the ligation of the intersphincteric fistula tract (LIFT) procedure for transsphincteric fistula-in-ano.
  
  
  METHODS
  A total of 43 patients that were treated with LIFT procedure and had a follow-up time of more than 1 year were included.
  
  
  RESULTS
  The median age was 37.18 years, and 32 (74.4%) of the patients were male. The median follow-up time was 26.2 months (range 13-63 months). There were 29 (67.4%) uncomplicated transsphincteric fistulas, 10 (23.3%) horseshoe transsphincteric fistulas, and 4 (9.3%) multiple fistulas. Eight (18.5%) patients presented with dehiscence or infection at the intersphincteric wound and were successfully treated with either laying open (n = 5) or local application of silver nitrate (n = 3). The success rate, as determined from the last follow-up time point, was 83.7% (36/43). The mean time to complete failure was 8.6 weeks (range 1-28) in 7 patients. With the exception of these 7 patients, 32/36 (88.9%) patients had a Cleveland Clinic Florida Faecal incontinence score of 0, 3 patients had a score of 1, and 1 had a score of 2. No significant association was found between laying open and incontinence in these partial failure patients.
  
  
  CONCLUSIONS
  The LIFT procedure can be considered an effective sphincter-sparing procedure in the management of transsphincteric fistula with an acceptable long-term outcome.
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
authors.forename: Hong-Jin
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
authors.forename: Gui-Dong
authors.initials: GD
authors.lastname: Sun
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
authors.forename: Zai-Long
authors.initials: ZL
authors.lastname: Zhou
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
authors.forename: Yu-Gen
authors.initials: YG
authors.lastname: Chen
authors.affiliation: Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. blyang1971@163.com.
authors.forename: Bo-Lin
authors.initials: BL
authors.lastname: Yang
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ligation of intersphincteric fistula tract; Long-term outcome; Transsphincteric anal fistula