PMID- 24374520
OWN - NLM
STAT- MEDLINE
DCOM- 20150109
LR  - 20221207
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 260
IP  - 6
DP  - 2014 Dec
TI  - A prospective evaluation of the ligation of the intersphincteric tract procedure 
      for complex anal fistula in patients with Crohn's disease.
PG  - 1057-61
LID - 10.1097/SLA.0000000000000479 [doi]
AB  - OBJECTIVE: To evaluate 2- and 12-month outcomes after ligation of the 
      intersphincteric fistula tract (LIFT) in Crohn's disease (CD). BACKGROUND: 
      Surgical approaches to perianal fistulas in CD are frequently ineffective and 
      hampered by concerns over adequate wound healing and sphincter injury. The 
      efficacy of LIFT in CD patients is unknown. METHODS: Consecutive cases of CD 
      patients with transsphincteric fistulas were prospectively analyzed. Fistula 
      healing and 2 validated quality-of-life indices were assessed. RESULTS: Fifteen 
      CD patients (9 women; mean age = 34.8 years) were identified. Location of the 
      fistula was lateral (n = 10; 67%) or midline (n = 5; 33%). LIFT site healing was 
      seen in 9 patients (60%) at 2-month follow-up. No patient developed fecal 
      incontinence. LIFT site healing was seen in 8 of the 12 patients (67%) with 
      complete 12-month follow-up. Significant factors for long-term LIFT site healing 
      were lateral versus midline location (P = 0.02) and longer mean fistula length (P 
      = 0.02). Patients who had successful operations significantly improved both their 
      mean Wexner Perianal Crohn's Disease Activity Index and McMaster Perianal Crohn's 
      Disease Activity Index quality-of-life scores at 2-month follow-up (14.0-3.8, P = 
      0.001, and 10.4-1.8, P = 0.0001, respectively). CONCLUSIONS: CD-associated anal 
      fistulas may be treated with LIFT. This surgical procedure is a safe, outpatient 
      procedure that minimizes both perianal wound creation and sphincter injury.
FAU - Gingold, Daniel S
AU  - Gingold DS
AD  - From the Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los 
      Angeles, CA.
FAU - Murrell, Zuri A
AU  - Murrell ZA
FAU - Fleshner, Phillip R
AU  - Fleshner PR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
MH  - Adult
MH  - Anal Canal/*surgery
MH  - Crohn Disease/*complications/surgery
MH  - Digestive System Surgical Procedures/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Ligation/methods
MH  - Male
MH  - Prospective Studies
MH  - Quality of Life
MH  - Plastic Surgery Procedures
MH  - Rectal Fistula/diagnosis/etiology/*surgery
MH  - *Surgical Flaps
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2014/01/01 06:00
MHDA- 2015/01/13 06:00
CRDT- 2013/12/31 06:00
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2015/01/13 06:00 [medline]
AID - 10.1097/SLA.0000000000000479 [doi]
PST - ppublish
SO  - Ann Surg. 2014 Dec;260(6):1057-61. doi: 10.1097/SLA.0000000000000479.