PMID- 36519904
OWN - NLM
STAT- MEDLINE
DCOM- 20221219
LR  - 20230406
IS  - 1879-1190 (Electronic)
IS  - 1072-7515 (Linking)
VI  - 236
IP  - 1
DP  - 2023 Jan 1
TI  - Ligation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for 
      High-Type Fistula in Ano: A Randomized Controlled Trial.
PG  - 27-35
LID - 10.1097/XCS.0000000000000441 [doi]
AB  - BACKGROUND: This study aimed to compare the postoperative outcomes and success 
      rate of the endorectal advancement flap and ligation of intersphincteric 
      fistulous tract (LIFT) in high-type fistula in ano. STUDY DESIGN: This randomized 
      control trial included patients with high-type fistula in ano of cryptoglandular 
      origin. The primary endpoint was complete fistula healing at the end of 6 months. 
      However, the patients were followed up for 2 years. Other parameters studied were 
      perioperative complications, duration of surgery, postoperative pain, hospital 
      stay in hours, continence, and quality of life at 6 months. RESULTS: A total of 
      84 patients were recruited (42 in each group). The healing rate in the LIFT arm 
      was better than that in the endorectal advancement flap arm (76.2.% vs 54.7%, p = 
      0.039). Four patients in the endorectal advancement flap group and two in the 
      LIFT group had flatus incontinence at the end of 6 months, but all were continent 
      at 2 years. At the end of the first week, the Visual Analog Scale score and 
      quality of life at 6 months were better in the LIFT arm (3.7 +/- 1.16 vs 4.7 +/- 0.81 
      and 0.7 vs 0.6, p < 0.05). The mean duration of surgery was significantly less in 
      the LIFT group (46.43 +/- 9.32 vs 89.29 +/- 10.90 minutes). None had any 
      postoperative complications, and >80% were discharged within 24 hours. 
      CONCLUSIONS: The shorter operative duration, better quality of life at 6 months, 
      and higher healing rate make LIFT a superior treatment option for high fistula in 
      ano. However, studies with a large sample size will be needed to verify these 
      results.
CI  - Copyright (c) 2022 by the American College of Surgeons. Published by Wolters Kluwer 
      Health, Inc. All rights reserved.
FAU - Kumar, Pankaj
AU  - Kumar P
AD  - From the Department of General Surgery, All India Institute of Medical Sciences, 
      Bhubaneswar, India.
FAU - Sarthak, Siddhant
AU  - Sarthak S
FAU - Singh, Pradeep K
AU  - Singh PK
FAU - Mishra, Tushar S
AU  - Mishra TS
FAU - Sasmal, Prakash K
AU  - Sasmal PK
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20221215
PL  - United States
TA  - J Am Coll Surg
JT  - Journal of the American College of Surgeons
JID - 9431305
SB  - IM
MH  - Humans
MH  - Quality of Life
MH  - *Rectal Fistula/surgery/complications
MH  - Ligation/methods
MH  - Surgical Flaps
MH  - Postoperative Complications/epidemiology/etiology
MH  - Treatment Outcome
MH  - Recurrence
MH  - Anal Canal/surgery
MH  - *Fecal Incontinence/etiology
EDAT- 2022/12/16 06:00
MHDA- 2022/12/20 06:00
CRDT- 2022/12/15 09:05
PHST- 2022/12/16 06:00 [pubmed]
PHST- 2022/12/20 06:00 [medline]
PHST- 2022/12/15 09:05 [entrez]
AID - 00019464-202301000-00006 [pii]
AID - 10.1097/XCS.0000000000000441 [doi]
PST - ppublish
SO  - J Am Coll Surg. 2023 Jan 1;236(1):27-35. doi: 10.1097/XCS.0000000000000441. Epub 
      2022 Dec 15.