PMID- 32813119
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1128-045X (Electronic)
IS  - 1123-6337 (Linking)
VI  - 24
IP  - 12
DP  - 2020 Dec
TI  - Porcine dermal collagen mesh (Permacol) as a bioprosthesis in the ligation of 
      intersphincteric tract (BioLIFT) procedure.
PG  - 1277-1283
LID - 10.1007/s10151-020-02325-3 [doi]
AB  - BACKGROUND: Ligation of intersphincteric tract (LIFT) is a sphincter-saving 
      technique used to treat anal fistulas. Incorporation of a bioprosthesis in LIFT 
      (BioLIFT) aims to improve healing. The use of cross-linked porcine dermal 
      collagen mesh Permacol in BioLIFT has never been investigated. The aim of this 
      study was to compare the healing rates and outcome of LIFT and BioLIFT for 
      complex anal fistulas using the Permacol biological mesh. METHODS: A 
      retrospective analysis of all patients having LIFT or BioLIFT for complex 
      fistulas from January 2010 to November 2019 was performed in a tertiary referral 
      centre. Patient data from a prospectively collected database of all patients 
      having LIFT or BioLIFT were analyzed. RESULTS: LIFT and BioLIFT were performed in 
      48 (82.8%) and 10 (17.2%) patients, respectively. All BioLIFT patients had 
      previous interventions for their fistulas compared to 30 (62.5%) of patients who 
      had LIFT, p = 0.023. The primary healing rate for LIFT was 87.5% (42/48) compared 
      to 80% (8/10) in BioLIFT, (p = 0.42). Eight (13.8%) patients developed 
      complications, 6 (12.5%) in the LIFT group vs 2 (20%) in the BioLIFT group 
      (p = 0.62). On univariate analysis, the number of previous operations was 
      predictive of complications (p = 0.03). BioLIFT was not associated with 
      complication (OR = 1.75, 95% CI: 0.30-10.3, p = 0.54) or primary healing 
      (OR = 0.57, 95% CI: 0.97-3.36, p = 0.54). There was no significant difference in 
      recurrence (LIFT 12.5% vs BioLIFT 0%, p = 0.58). Kaplan-Meier analysis found no 
      difference in time to recurrence between the two groups (p = 0.65). CONCLUSION: 
      Permacol mesh in BioLIFT is feasible and achieves a high primary healing rate of 
      80%. Prospective evidence is needed to establish the benefits of BioLIFT and 
      determine whether Permacol is superior to the non-cross-linked porcine 
      submucosal mesh.
FAU - Tsang, J S
AU  - Tsang JS
AUID- ORCID: 0000-0002-5614-413X
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR. julianst@yahoo.com.
FAU - Chan, T Y
AU  - Chan TY
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR.
FAU - Cheung, H H
AU  - Cheung HH
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR.
FAU - Wei, R
AU  - Wei R
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR.
FAU - Foo, C C
AU  - Foo CC
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR.
FAU - Lo, O S H
AU  - Lo OSH
AD  - Division of Colorectal Surgery, Department of Surgery, Queen Mary Hospital, 
      University of Hong Kong, Pok Fu Lam, Hong Kong, SAR.
LA  - eng
PT  - Journal Article
DEP - 20200819
PL  - Italy
TA  - Tech Coloproctol
JT  - Techniques in coloproctology
JID - 9613614
RN  - 9007-34-5 (Collagen)
SB  - IM
MH  - Anal Canal
MH  - Animals
MH  - *Bioprosthesis
MH  - Collagen
MH  - Humans
MH  - Ligation
MH  - Prospective Studies
MH  - *Rectal Fistula
MH  - Recurrence
MH  - Retrospective Studies
MH  - Surgical Mesh
MH  - Swine
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anal fistula
OT  - BioLIFT
OT  - Ligation of intersphincteric tract
EDAT- 2020/08/20 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/08/20 06:00
PHST- 2020/06/29 00:00 [received]
PHST- 2020/08/06 00:00 [accepted]
PHST- 2020/08/20 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/08/20 06:00 [entrez]
AID - 10.1007/s10151-020-02325-3 [pii]
AID - 10.1007/s10151-020-02325-3 [doi]
PST - ppublish
SO  - Tech Coloproctol. 2020 Dec;24(12):1277-1283. doi: 10.1007/s10151-020-02325-3. 
      Epub 2020 Aug 19.