Results from a novel modification to the ligation intersphincteric fistula tract

Background: The ligation of intersphincteric fistula tract (LIFT) procedure for trans-sphincteric fistula-in-ano has been studied with variable success rates compared with initial reports. Failures occur mostly in the intersphincteric wound. Recently, we proposed a modification to LIFT, unroofing the fistula from internal opening to intersphincteric groove, ligating the fistula tract, but preserving the external sphincter.

Methods: This retrospective review assesses outcomes of patients undergoing the modified LIFT for trans-sphincteric fistulae.

Results: Sixty-six modified LIFT procedures were performed. The main cohort consisted of 56 patients, predominantly men (76.7%). Median operative time was 16 minutes. Median follow-up was 20.98 weeks. Overall cure rate was 71.42%, with a recurrence rate of 5.35% and fistula persistence in 16.07%. There was no persistent fecal incontinence.

Conclusion: Modified LIFT is a safe procedure that is easily performed, has short operative time, eliminates the intersphincteric space, and has cure rates equal to or better than the original LIFT.