PMID- 31183438
OWN - NLM
STAT- MEDLINE
DCOM- 20200409
LR  - 20200409
IS  - 2474-9842 (Electronic)
IS  - 2474-9842 (Linking)
VI  - 3
IP  - 3
DP  - 2019 Jun
TI  - Systematic review and meta-analysis of endorectal advancement flap and ligation 
      of the intersphincteric fistula tract for cryptoglandular and Crohn's high 
      perianal fistulas.
PG  - 231-241
LID - 10.1002/bjs5.50129 [doi]
AB  - BACKGROUND: High perianal fistulas require sphincter-preserving surgery because 
      of the risk of faecal incontinence. The ligation of the intersphincteric fistula 
      tract (LIFT) procedure preserves anal sphincter function and is an alternative to 
      the endorectal advancement flap (AF). The aim of this study was to evaluate 
      outcomes of these procedures in patients with cryptoglandular and Crohn's 
      perianal fistulas. METHODS: A systematic literature search was performed using 
      MEDLINE, Embase and the Cochrane Library. All RCTs, cohort studies and case 
      series (more than 5 patients) describing one or both techniques were included. 
      Main outcomes were overall success rate, recurrence and incontinence following 
      either technique. A proportional meta-analysis was performed using a 
      random-effects model. RESULTS: Some 30 studies comprising 1295 patients were 
      included (AF, 797; LIFT, 498). For cryptoglandular fistula (1098 patients), there 
      was no significant difference between AF and LIFT for weighted overall success 
      (74.6 (95 per cent c.i. 65.6 to 83.7) versus 69.1 (53.9 to 84.3) per cent 
      respectively) and recurrence (25.6 (4.7 to 46.4) versus 21.9 (14.8 to 29.0) per 
      cent) rates. For Crohn's perianal fistula (64 patients), no significant 
      differences were observed between AF and LIFT for overall success rate (61 (45 to 
      76) versus 53 per cent respectively), but data on recurrence were limited. 
      Incontinence rates were significantly higher after AF compared with LIFT (7.8 
      (3.3 to 12.4) versus 1.6 (0.4 to 2.8) per cent). CONCLUSION: Overall success and 
      recurrence rates were not significantly different between the AF and LIFT 
      procedure, but continence was better preserved after LIFT.
FAU - Stellingwerf, M E
AU  - Stellingwerf ME
AUID- ORCID: 0000-0002-8447-6254
AD  - Department of Surgery Amsterdam UMC, University of Amsterdam Amsterdam the 
      Netherlands.
FAU - van Praag, E M
AU  - van Praag EM
AD  - Department of Surgery Amsterdam UMC, University of Amsterdam Amsterdam the 
      Netherlands.
FAU - Tozer, P J
AU  - Tozer PJ
AD  - Robin Phillips Fistula Research Unit, St Mark's Hospital and Academic Institute 
      Harrow HA1 3UJ UK.
FAU - Bemelman, W A
AU  - Bemelman WA
AD  - Department of Surgery Amsterdam UMC, University of Amsterdam Amsterdam the 
      Netherlands.
FAU - Buskens, C J
AU  - Buskens CJ
AD  - Department of Surgery Amsterdam UMC, University of Amsterdam Amsterdam the 
      Netherlands.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20190121
PL  - England
TA  - BJS Open
JT  - BJS open
JID - 101722685
EIN - BJS Open. 2020 Feb;4(1):166-167. PMID: 32011811
MH  - Adult
MH  - Anal Canal/*pathology/surgery
MH  - Crohn Disease/complications
MH  - Cutaneous Fistula/complications
MH  - Digestive System Surgical Procedures/*methods/trends
MH  - Fecal Incontinence/epidemiology
MH  - Female
MH  - Humans
MH  - Ligation/adverse effects/*methods
MH  - Male
MH  - Middle Aged
MH  - Rectal Fistula/etiology/*surgery
MH  - Recurrence
MH  - Surgical Flaps
MH  - Treatment Outcome
PMC - PMC6551488
EDAT- 2019/06/12 06:00
MHDA- 2019/06/12 06:01
PMCR- 2019/01/21
CRDT- 2019/06/12 06:00
PHST- 2018/06/29 00:00 [received]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2019/06/12 06:00 [entrez]
PHST- 2019/06/12 06:00 [pubmed]
PHST- 2019/06/12 06:01 [medline]
PHST- 2019/01/21 00:00 [pmc-release]
AID - BJS550129 [pii]
AID - 10.1002/bjs5.50129 [doi]
PST - epublish
SO  - BJS Open. 2019 Jan 21;3(3):231-241. doi: 10.1002/bjs5.50129. eCollection 2019 
      Jun.