EC Gastroenterology and Digestive System

Research Article Volume 11 Issue 2 - 2024

LIFT in Anal Fistula-A Systematic Review

Ovi MRA1*, Nasrin S2, Talukdar MMI3, Islam N4 and Jalal MT5

1Junior Consultant, Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2Assistant Professor, Department of Colorectal Surgery, Anwer Khan Modern Medical College Hospital, Dhaka, Bangladesh
3Junior Consultant, Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4Assistant Professor, Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh
5Associate Professor, Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
*Corresponding Author: Ovi MRA, Junior Consultant, Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Received: January 08, 2024; Published: January 24, 2024



Background: The procedure known as ligation of the intersphincteric fistula tract (LIFT) is used to treat anal fistulas while preserving the sphincter. Numerous studies have been conducted to evaluate the effectiveness of this procedure, yielding different outcomes.

Aim of the Study: The aim of this review is to evaluate the pertinent literature related to this subject.

Methods: The review used the PRISMA statement. The search engines PubMed, Google Scholar and Medline were searched for articles published in English.

Result: Fifteen papers were reviewed from a pool of 108 papers. The total number of patients included was 539.The main outcomes measured were healing rates, duration of follow-up, recurrence rate, and post-operative incontinence. Specifics of the surgical method were the following goals. The majority of studies examined in this review involved patients who had trans-sphincteric or complex fistulas that were not suitable for treatment with fistulotomy.

Conclusion: The LIFT procedure is considered a relatively new, cost-effective, and easily learnable method for preserving the sphincter muscle while treating fistulas. It has shown promising results in terms of safety, feasibility, and positive outcomes in both the short and long term.

 Keywords: Incontinence; Recurrence; Complex Fistula; LIFT

 

  1. Shawki S and Wexner SD. “Idiopathic fistula-in-ano”. World Journal of Gastroenterology 28 (2011): 3277-3285.
  2. Steele SR., et al. “Practice parameters for the management of perianal abscess and fistula-in-ano”. Diseases of the Colon and Rectum12 (2011): 1465-1474.
  3. Williams JG., et al. “Seton treatment of high anal fistulae”. British Journal of Surgery10 (1991): 1159-1161.
  4. Sentovich SM. “Fibrin glue for anal fistulas: long-term results”. Diseases of the Colon and Rectum 4 (2003): 498-502.
  5. Garg P., et al. “The efficacy of anal fistula plug in fistula-in-ano: a systematic review: The efficacy of AFP in fistula-in-ano: a review”. Colorectal Disease10 (2010): 965-970.
  6. Johnson EK., et al. “Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas”. Diseases of the Colon and Rectum 3 (2006): 371-376.
  7. Bleier JIS., et al. “Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas”. Diseases of the Colon and Rectum 1 (2010): 43-46.
  8. Rojanasakul A., et al. “Total anal sphincter saving technique for fistula-in-ano the ligation of intersphincteric fistula tract”. Journal of Medical Association of Thailand 3 (2007): 581-586.
  9. Shanwani A., et al. “Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano”. Diseases of the Colon and Rectum 1 (2010): 39-42.
  10. Hong KD., et al. “Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula: systematic review and meta-analysis”. Techniques in Coloproctology8 (2014): 685-691.
  11. Van Onkelen RS., et al. “Ligation of the intersphincteric fistula tract in low transsphincteric fistula: a new technique to avoid fistulotomy”. Colorectal Disease5 (2012): 587-591.
  12. Ellis CN. “Outcomes with the use of bioprosthetic grafts to reinforce the ligation of the intersphincteric fistula tract (BioLIFT procedure) for the management of complex anal fistulas”. Diseases of the Colon and Rectum 10 (2010): 1361-1364.
  13. Han JG., et al. “Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug (LIFT‐Plug): a new technique for fistula‐in‐ano”. Colorectal Disease5 (2013): 582-586.
  14. Aboulian A., et al. “Early result of ligation of the intersphincteric fistula tract for fistula-in-ano”. Diseases of the Colon and Rectum 3 (2011): 289-292.
  15. Rojanasakul A. “LIFT procedure: a simplified technique for fistula-in-ano”. Techniques in Coloproctology 3 (2009): 237-240.
  16. Ooi K., et al. “Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience: Ligation of the intersphincteric fistula tract”. Colorectal Disease5 (2012): 599-603.
  17. Sileri P., et al. “Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study”. Techniques in Coloproctology 4 (2011): 413-416.
  18. Tan K-K., et al. “To LIFT or to flap? Which surgery to perform following seton insertion for high anal fistula?” Diseases of the Colon and Rectum 12 (2012): 1273-1277.
  19. Wallin UG., et al. “Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?” Diseases of the Colon and Rectum 11 (2012): 1173-1178.
  20. Abcarian AM., et al. “Ligation of intersphincteric fistula tract: early results of a pilot study”. Diseases of the Colon and Rectum 7 (2012): 778-782.
  21. Mushaya C., et al. “Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage”. American Journal of Surgery 3 (2012): 283-289.
  22. Liu WY., et al. “Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula-in-ano”. Diseases of the Colon and Rectum 3 (2013): 343-347.
  23. Lehmann J-P and Graf W. “Efficacy of LIFT for recurrent anal fistula”. Colorectal Disease5 (2013): 592-595.
  24. Sirikurnpiboon S., et al. “Ligation of intersphincteric fistula tract and its modification: Results from treatment of complex fistula”. World Journal of Gastrointestinal Surgery 4 (2013): 123-128.
  25. Ovi M., et al. “Comparative study between open fistulectomy and ligation of intersphincteric fistulas tract (lift) procedure for uncomplicated perianal fistula”. International Journal of Innovative Science and Research Technology8 (2020): 753-759.
  26. Matos D., et al. “Total sphincter conservation in high fistula in ano: results of a new approach”. British Journal of Surgery 6 (1993): 802-804.
  27. Schouten WR., et al. “Transanal advancement flap repair of transsphincteric fistulas”. Diseases of the Colon and Rectum 11 (1999): 1419-1422.
  28. Ortíz H and Marzo J. “Endorectal flap advancement repair and fistulectomy for high trans-sphincteric and suprasphincteric fistulas: Repair of complex anal fistula”. British Journal of Surgery 12 (2000): 1680-1683.
  29. van Onkelen RS., et al. “Ligation of the intersphincteric fistula tract in low transsphincteric fistulae: a new technique to avoid fistulotomy: LIFT in low transsphincteric fistulae”. Colorectal Disease5 (2013): 587-591.
  30. van der Hagen SJ., et al. “Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas: recurrent perianal fistulas: failure of treatment or recurrent patient disease?: Recurrent perianal fistulas: failure of treatment or recurrent patient disease?” International Journal of Colorectal Disease 8 (2006): 784-790.
  31. Mitalas LE., et al. “Identification of epithelialization in high transsphincteric fistulas”. Techniques in Coloproctology 2 (2012): 113-117.

Ovi MRA., et al. “LIFT in Anal Fistula-A Systematic Review".  11.1 (2024): 01-15.