Keywords : low anal fistula
A comparative study of ligation of intersphincteric fistula tract versus conventional fistulectomy in management of low fistula in ano
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 1977-1983
Background: Fistula in ano is one of the common anorectal disorders which is defined as an abnormal track connecting the anal canal with perineum. The main objective of the treatment in fistula-in-ano is to minimize recurrence while maintaining anal continence. Present study was aimed to compare ligation of intersphincteric fistula tract versus conventional fistulectomy in management of low fistula in ano at a tertiary hospital.
Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients of age >15 years, of either gender with low anal fistula identified by clinical examination and investigations.
Results: 60 patients were divided into two groups as group A underwent ligation of intersphincteric fistula tract (LIFT) procedure (n=30) and group B, underwent open fistulectomy (n=30). In present study among both groups majority patients were male & from 31-60 years age group. Mean duration of surgery was comparable & difference was not significant statistically (26.9 ± 9.4 minutes vs 30.7 ± 11.6 minutes). Duration of wound healing was less in LIFT group as compared to fistulectomy group & difference was statistically significant (12.6 ± 5.7 days vs 18.5 ± 8.7 days) (p value< 0.001). Post-operative pain scores were comparable among two groups on post-operative day 0 & 1. Less post-operative pain scores were noted among in LIFT group as compared to fistulectomy group on post-operative day 3 & 7, difference was statistically significant (p value < 0.05). Less complications were noted in LIFT group as compared to fistulectomy group; difference was not significant statistically.
Conclusion: Ligation of intersphincteric fistula tract (LIFT) procedure for the management low anal fistula is simple, safe and effective in management of low anal fistulas, produces less post-operative pain, faster wound healing and better fecal continence preservation compared to open fistulectomy.