PMID- 30184334
OWN - NLM
STAT- MEDLINE
DCOM- 20200401
LR  - 20200401
IS  - 1463-1318 (Electronic)
IS  - 1462-8910 (Linking)
VI  - 21
IP  - 1
DP  - 2019 Jan
TI  - Long-term outcomes and quality of life following ligation of the intersphincteric 
      fistula tract for high transsphincteric fistulas.
PG  - 30-37
LID - 10.1111/codi.14405 [doi]
AB  - AIM: Published outcomes following ligation of the intersphincteric fistula tract 
      (LIFT) for high transsphincteric fistulas (HTFs) are equivocal probably because 
      most trials are small and comprise mixed patient populations. The aim of this 
      study was to highlight the long-term efficacy of LIFT for HTFs in a large 
      homogeneous sample and to determine the risk factors that contribute to 
      non-healing resulting in failure and recurrence. METHOD: A retrospective study 
      was performed which assessed patients with HTFs treated by LIFT without prior 
      loose setons from September 2012 to December 2017. Continence function was 
      evaluated by the Wexner incontinence scale and anal manometry. Quality of life 
      was assessed by using the faecal incontinence quality of life (FIQL) scale with 
      four domains: lifestyle, coping, depression and embarrassment. RESULTS: Seventy 
      patients with HTFs underwent 71 LIFT procedures. The primary healing rate was 
      81.7% with a median follow-up duration of 16.5 (range 4.5-68) months. The healing 
      rates of mature and immature fistulas were 83.7% and 77.3%, respectively. Two 
      patients suffered failure with an unhealed intersphincteric wound. Recurrence 
      occurred in 11 patients. Incontinence of flatus, present in four patients before 
      surgery, improved postoperatively. Two patients undergoing LIFT combined with 
      fistulotomy complained of flatus incontinence after surgery. No significant 
      differences between preoperative and postoperative Wexner score, maximum resting 
      pressure and maximum squeeze pressure were detected. The FIQL was improved in 
      lifestyle, coping and depression. No risk factor for non-healing was found. 
      CONCLUSION: LIFT has a promising long-term outcome for HTFs, with negligible 
      impairment on continence and improved quality of life.
CI  - Colorectal Disease (c) 2018 The Association of Coloproctology of Great Britain and 
      Ireland.
FAU - Sun, X-L
AU  - Sun XL
AD  - Department of Colorectal Surgery, Suzhou Affiliated Hospital of Nanjing 
      University of Chinese Medicine, Suzhou, 215000, Jiangsu Province, China.
FAU - Wen, K
AU  - Wen K
AD  - Department of Colorectal Surgery, Suzhou Affiliated Hospital of Nanjing 
      University of Chinese Medicine, Suzhou, 215000, Jiangsu Province, China.
FAU - Chen, Y-H
AU  - Chen YH
AD  - Department of Colorectal Surgery, Suzhou Affiliated Hospital of Nanjing 
      University of Chinese Medicine, Suzhou, 215000, Jiangsu Province, China.
FAU - Xu, Z-Z
AU  - Xu ZZ
AD  - Department of Colorectal Surgery, Suzhou Affiliated Hospital of Nanjing 
      University of Chinese Medicine, Suzhou, 215000, Jiangsu Province, China.
FAU - Wang, X-P
AU  - Wang XP
AD  - Department of Colorectal Surgery, Suzhou Affiliated Hospital of Nanjing 
      University of Chinese Medicine, Suzhou, 215000, Jiangsu Province, China.
LA  - eng
PT  - Journal Article
DEP - 20181121
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  - Adaptation, Psychological
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anal Canal/*surgery
MH  - Depression/*psychology
MH  - Female
MH  - Humans
MH  - Ligation/*methods
MH  - Male
MH  - Middle Aged
MH  - Quality of Life/*psychology
MH  - Rectal Fistula/psychology/*surgery
MH  - Recurrence
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - anal fistula
OT  - anal manometry
OT  - ligation of the intersphincteric fistula tract
OT  - transsphincteric fistula
EDAT- 2018/09/06 06:00
MHDA- 2020/04/02 06:00
CRDT- 2018/09/06 06:00
PHST- 2018/02/25 00:00 [received]
PHST- 2018/08/13 00:00 [accepted]
PHST- 2018/09/06 06:00 [pubmed]
PHST- 2020/04/02 06:00 [medline]
PHST- 2018/09/06 06:00 [entrez]
AID - 10.1111/codi.14405 [doi]
PST - ppublish
SO  - Colorectal Dis. 2019 Jan;21(1):30-37. doi: 10.1111/codi.14405. Epub 2018 Nov 21.