PMID- 28371062
OWN - NLM
STAT- MEDLINE
DCOM- 20180501
LR  - 20191210
IS  - 1463-1318 (Electronic)
IS  - 1462-8910 (Linking)
VI  - 19
IP  - 8
DP  - 2017 Aug
TI  - Increasing experience of ligation of the intersphincteric fistula tract for 
      patients with Crohn's disease: what have we learned?
PG  - 750-755
LID - 10.1111/codi.13668 [doi]
AB  - AIM: Ligation of the intersphincteric fistula tract (LIFT) has been proposed as a 
      treatment of trans-sphincteric fistula in perianal Crohn's disease (CD). The aim 
      of this study was to look at our experience of the LIFT procedure in CD patients 
      on long-term follow-up. Specifically, we aimed to determine the fistula healing 
      rate after the LIFT procedure after more than 12 months follow-up and to identify 
      any prognostic factors. METHOD: Retrospective study of patients with 
      trans-sphincteric Crohn's fistula tracts treated with the LIFT procedure between 
      January 2011 and October 2015. Complete fistula healing as well as clinical 
      outcomes were analysed. RESULTS: Data were available for 23 patients. After a 
      median follow-up of 23 months, LIFT site healing was 48%. Patients with healed 
      LIFT had a median follow-up time of 10.5 months, while patients with failed LIFT 
      had a median follow-up time of 31 months (P = 0.04). Median time to failure was 
      9 months for patients with follow-up > 1 year. Most patients failed within 1 year 
      (9/12; 75%) of the procedure. In multi-site CD, the LIFT procedure was more 
      likely to be successful in those with small bowel disease (P = 0.04) compared 
      with colonic disease (P = 0.02). Other factors such as preoperative use of 
      biological therapies, presence of a seton, previous repair attempts, fistula 
      position, type or number of fistulas, multiple fistula tracts, smoking status and 
      other associated perianal disease did not appear to influence LIFT healing rates. 
      CONCLUSION: The LIFT procedure offers reasonable long-term success in the 
      treatment of perianal trans-sphincteric fistulas associated with CD. LIFT is more 
      likely to fail in patients with concurrent colonic CD than in patients with small 
      bowel CD.
CI  - Colorectal Disease (c) 2017 The Association of Coloproctology of Great Britain and 
      Ireland.
FAU - Kaminski, J P
AU  - Kaminski JP
AD  - Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, 
      California, USA.
FAU - Zaghiyan, K
AU  - Zaghiyan K
AD  - Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, 
      California, USA.
FAU - Fleshner, P
AU  - Fleshner P
AD  - Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, 
      California, USA.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - Colorectal Dis
JT  - Colorectal disease : the official journal of the Association of Coloproctology of 
      Great Britain and Ireland
JID - 100883611
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anal Canal/*surgery
MH  - Colon/pathology
MH  - Crohn Disease/*complications/pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intestine, Small/pathology
MH  - Ligation/*methods
MH  - Male
MH  - Middle Aged
MH  - Rectal Fistula/*surgery
MH  - Recurrence
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Crohn's
OT  - LIFT
OT  - fistula
EDAT- 2017/04/04 06:00
MHDA- 2018/05/02 06:00
CRDT- 2017/04/04 06:00
PHST- 2016/10/12 00:00 [received]
PHST- 2016/12/20 00:00 [accepted]
PHST- 2017/04/04 06:00 [pubmed]
PHST- 2018/05/02 06:00 [medline]
PHST- 2017/04/04 06:00 [entrez]
AID - 10.1111/codi.13668 [doi]
PST - ppublish
SO  - Colorectal Dis. 2017 Aug;19(8):750-755. doi: 10.1111/codi.13668.