Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano
Background: Treatment of trans-sphincteric fistulas with fistulectomy involves a large wound with risk of incontinence and recurrence. Procedure of Ligation of Inter-sphincteric Fistula Tract (LIFT) approach emerged recently and expected to provide more favorable outcomes and less risk of incontinen...
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South Valley University, Faculty of Medicine
2024-07-01
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| Series: | SVU - International Journal of Medical Sciences |
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| Online Access: | https://svuijm.journals.ekb.eg/article_381183.html |
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| author | Ayman Helmy Ibrahim * |
| author_facet | Ayman Helmy Ibrahim * |
| author_sort | Ayman Helmy Ibrahim * |
| collection | DOAJ |
| description | Background: Treatment of trans-sphincteric fistulas with fistulectomy involves a large wound with risk of incontinence and recurrence. Procedure of Ligation of Inter-sphincteric Fistula Tract (LIFT) approach emerged recently and expected to provide more favorable outcomes and less risk of incontinence.
Objectives: This comparative study was done to evaluate operative and postoperative outcomes of LIFT procedure in comparison with traditional fistulectomy in treatment of trans-sphincteric fistulas.
Patients and methods: Study was carried out on 48 patients with trans-sphincteric fistulas assigned into 2 groups; group A treated with LIFT included 23 patients and group B treated with fistulectomy done in 25 patients.
Results: Mean operative time was significantly shorter in group A than in group B (p = 0.001). Postoperative pain means sores were significantly less in LIFT group; than in groups A and B respectively (p = 0.04), while hospital stay showed no statistical significance; in group A versus in group B (p= 0.25). The mean wound healing in LIFT group was significantly shorter than in fistulectomy group (p = 0.003). As regard postoperative complications in groups A and B, infection reported in 4 & 7 patients (17.3% & 28%), minor bleeding in 2 & 4 patients (8.6% & 16 %) respectively, no incontinence reported in group A and 3 patients shown temporary incontinence to flatus in group B. Overall recurrence was 31.2 % (15 patients); 6 patients (26.1 %) post-LIFT and 9 patients (36 %) post-fistulectomy includes failure of healing (3 post-LIFT and 5 post-fistulectomy), difference in recurrence was insignificant (p = 0.3).
Conclusion: LIFT procedure offers a shorter operative time, lower postoperative pain, faster wound healing and low incidence of incontinence in comparison to fistulectomy while recurrence rate was insignificantly different. |
| format | Article |
| id | doaj-art-7f019eff1bdc4d52856f456f4424466d |
| institution | OA Journals |
| issn | 2735-427X 2636-3402 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | South Valley University, Faculty of Medicine |
| record_format | Article |
| series | SVU - International Journal of Medical Sciences |
| spelling | doaj-art-7f019eff1bdc4d52856f456f4424466d2025-08-20T01:55:18ZengSouth Valley University, Faculty of MedicineSVU - International Journal of Medical Sciences2735-427X2636-34022024-07-0172491500https://doi.org/10.21608/svuijm.2024.313168.1966Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in AnoAyman Helmy Ibrahim *0Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, EgyptBackground: Treatment of trans-sphincteric fistulas with fistulectomy involves a large wound with risk of incontinence and recurrence. Procedure of Ligation of Inter-sphincteric Fistula Tract (LIFT) approach emerged recently and expected to provide more favorable outcomes and less risk of incontinence. Objectives: This comparative study was done to evaluate operative and postoperative outcomes of LIFT procedure in comparison with traditional fistulectomy in treatment of trans-sphincteric fistulas. Patients and methods: Study was carried out on 48 patients with trans-sphincteric fistulas assigned into 2 groups; group A treated with LIFT included 23 patients and group B treated with fistulectomy done in 25 patients. Results: Mean operative time was significantly shorter in group A than in group B (p = 0.001). Postoperative pain means sores were significantly less in LIFT group; than in groups A and B respectively (p = 0.04), while hospital stay showed no statistical significance; in group A versus in group B (p= 0.25). The mean wound healing in LIFT group was significantly shorter than in fistulectomy group (p = 0.003). As regard postoperative complications in groups A and B, infection reported in 4 & 7 patients (17.3% & 28%), minor bleeding in 2 & 4 patients (8.6% & 16 %) respectively, no incontinence reported in group A and 3 patients shown temporary incontinence to flatus in group B. Overall recurrence was 31.2 % (15 patients); 6 patients (26.1 %) post-LIFT and 9 patients (36 %) post-fistulectomy includes failure of healing (3 post-LIFT and 5 post-fistulectomy), difference in recurrence was insignificant (p = 0.3). Conclusion: LIFT procedure offers a shorter operative time, lower postoperative pain, faster wound healing and low incidence of incontinence in comparison to fistulectomy while recurrence rate was insignificantly different.https://svuijm.journals.ekb.eg/article_381183.htmlligation trans-sphincteric fistula tractfistulectomy ano granulomatous |
| spellingShingle | Ayman Helmy Ibrahim * Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano SVU - International Journal of Medical Sciences ligation trans-sphincteric fistula tract fistulectomy ano granulomatous |
| title | Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano |
| title_full | Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano |
| title_fullStr | Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano |
| title_full_unstemmed | Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano |
| title_short | Comparative Study between Ligation of Trans-sphincteric Fistula Tract and Fistulectomy in Treatment of Fistula in Ano |
| title_sort | comparative study between ligation of trans sphincteric fistula tract and fistulectomy in treatment of fistula in ano |
| topic | ligation trans-sphincteric fistula tract fistulectomy ano granulomatous |
| url | https://svuijm.journals.ekb.eg/article_381183.html |
| work_keys_str_mv | AT aymanhelmyibrahim comparativestudybetweenligationoftranssphinctericfistulatractandfistulectomyintreatmentoffistulainano |