ABSTRACT
Objective To evaluate the clinical effects of modified ligation of the fistula tract (LIFT)in the treatment of simple transsphincteric anal fistula.Methods 92 patients with a clinical diag-nosis of simple transsphincteric anal fistula were enrolled into the research.According to the random num-ber table patients divided into the modified group(46 cases)and the normal group(46 cases)randomly. Operation time,postoperative pain score,postoperative hospitalization time,healing time and healing rate in two groups were compared,Wexner anal incontinence scores and anorectal manometry 3 months after operation were analyzed to evaluated anal function.Results All patients were followed up for 3 ~26 months,average(8.73 ± 7.15)months.Comparing with operation time,hospitalization time,postoperative pain score 24 h after operation,hospital stay had no significantly different between the two groups(all P>0.05).The healing time had significantly different between the modified group[(10.14 ± 2.57)d]with the normal group[(23.87 ± 4.68)d](P<0.05);The healing rate in modified group was(91.2%)sig-nificantly higher thanin normal group(71.7%)(P<0.05).By the Wexner anal incontinence scores and anorectal manometry 3 months after operation were not significantly different(P>0.05).Conclusion Modified LIFT is a safe technique with a high healing rate and a shorter healing time,in the treatment of simple transsphincteric anal fistula,modified LIFT procedures should be considered.
ABSTRACT
PURPOSE: The complications after surgery for trans sphincteric anal fistula are anal incontinence due to cutting of the external anal sphincter muscle and recurrent anal fistula. Several methods have been developed to alleviate this condition, but they still have many complications. We performed surgery for transsphincteric anal fistula by a new method with excellent results and therefore report this new method as another treatment modality for transsphincteric anal fistula. METHODS: We performed surgery for transsphincteric anal fistula on 12 patients at Hanyang University Kuri Hospital between March 1999 and December 2001. RESULTS: There were no recurrences in any of the 12 patients, all of whom kept continence after surgery. Our operative method involve coring out and fistulectomy, laying open, closure of the defected external sphincter muscle and partial closure of the skin of the external opening. CONCLUSION: Our simple and modified method for transsphincteric anal fistula showed excellent results, especially in terms of the rate of recurrence and fecal incontinence. We therefore recommended this easy and simple method for surgery for transsphincteric anal fistula.