PMID- 23636215
OWN - NLM
STAT- MEDLINE
DCOM- 20140514
LR  - 20211021
IS  - 1432-1262 (Electronic)
IS  - 0179-1958 (Linking)
VI  - 28
IP  - 11
DP  - 2013 Nov
TI  - Appraisal of the LIFT and BIOLIFT procedure: initial experience and short-term 
      outcomes of 33 consecutive patients.
PG  - 1489-96
LID - 10.1007/s00384-013-1702-0 [doi]
AB  - PURPOSE: A new sphincter-saving technique known as the LIFT (ligation of 
      intersphincteric tract) procedure has gained growing interest. Use of a 
      bioprosthetic device has also been suggested to augment the LIFT procedure 
      (BIOLIFT). This study evaluates outcomes of patients undergoing LIFT and BIOLIFT 
      for repair of complex anal fistulae. METHODS: This study is a single-surgeon, 
      single-centre retrospective review of a prospectively collected database. Study 
      was conducted at Royal Prince Alfred Hospital Department of Colorectal Surgery, 
      Sydney, Australia, from May 2009 to April 2012. Thirty-three patients were 
      evaluated. Twenty-nine LIFTs and five BIOLIFT procedures were evaluated. Primary 
      success is defined as successful healing from initial procedure while secondary 
      success is successful healing after management of failure or recurrence. RESULTS: 
      In a cohort of predominantly female (67 %) and 94 % transsphincteric fistulae, 
      primary success was 63 %. At a median follow-up of 20 weeks (6-81 weeks), there 
      were 11 failures and one recurrence. The median time to failure/recurrence was 3 
      weeks (1-25 weeks). Six patients had a subsequent fistulotomy and three patients 
      had a BIOLIFT for non-successful outcomes. The median follow-up for those with 
      failures/recurrences is 60 weeks (range 20-76 weeks) and secondary success was 88 
      %. Post-operative anal manometry studies showed a 9 % reduction of resting and 11 
      % reduction of squeeze pressures but this was not statistically significant. 
      There was also no post-operative incontinence. Anterior fistulas were noted do 
      significantly worse (47%) compared with non-anteriorly located fistulas (84 %; 
      p = 0.03). CONCLUSIONS: LIFT and BIOLIFT procedures can be performed safely and 
      effectively in a technically demanding study cohort of predominantly females with 
      complex fistulas. Anterior fistulas have a higher risk of failure but present 
      early and are amendable to repeat procedures. In particular, fistulotomies are 
      useful in downstaged tracts and performing BIOLIFTs is an alternative in the 
      management of LIFT failures and recurrences.
FAU - Chew, Min-Hoe
AU  - Chew MH
AD  - Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, 
      Australia.
FAU - Lee, Peter J M
AU  - Lee PJ
FAU - Koh, Cherry E
AU  - Koh CE
FAU - Chew, Hwee E
AU  - Chew HE
LA  - eng
PT  - Journal Article
DEP - 20130501
PL  - Germany
TA  - Int J Colorectal Dis
JT  - International journal of colorectal disease
JID - 8607899
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anal Canal/pathology/*surgery
MH  - Cohort Studies
MH  - Demography
MH  - Digestive System Surgical Procedures/*methods
MH  - Female
MH  - Humans
MH  - Ligation
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/05/03 06:00
MHDA- 2014/05/16 06:00
CRDT- 2013/05/03 06:00
PHST- 2013/04/08 00:00 [accepted]
PHST- 2013/05/03 06:00 [entrez]
PHST- 2013/05/03 06:00 [pubmed]
PHST- 2014/05/16 06:00 [medline]
AID - 10.1007/s00384-013-1702-0 [doi]
PST - ppublish
SO  - Int J Colorectal Dis. 2013 Nov;28(11):1489-96. doi: 10.1007/s00384-013-1702-0. 
      Epub 2013 May 1.