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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 6/2020

01-06-2020 | Original Article

Lift and VAAFT for high trans-sphincteric anal fistula: a single center retrospective analysis

Authors: M. La Torre, G. Lisi, E. D’Agostino, M. Boccuzzi, M. Campanelli, M. Varriale, S. M. Tierno

Published in: International Journal of Colorectal Disease | Issue 6/2020

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Abstract

Purpose

The management of complex anal fistulas remains a challenge, mainly due to the considerable risk of incontinence. We compared LIFT and VAAFT in the treatment of complex anal fistulas in terms of healing time, recurrence, continence, morbidity, and postoperative pain, focusing also on patients with local abscess at the time of surgery.

Methods

We include all patients with high trans-sphincteric anal fistula even with abscess at the time of surgery. Anorectal manometry, endoanal ultrasound, Cleveland Clinic fecal incontinence score, VAS score, and number of previous fistula treatment were recorded. The clinical examination defined healing, insufficiency or recurrence of the fistula.

Results

Fifty-four consecutive patients are undergoing surgery: 26 patients underwent LIFT and 28 underwent VAAFT. During the 18 months of follow-up there were no differences in terms of AM, CCFIS and VAS scores. Days of healing, failure, and recurrence rate were comparable in both groups. The subgroup of patients with local abscess undergoing LIFT showed worse results in terms of failure and recurrence rate (p < 0.05).

Conclusions

Both techniques are safe and effective and can offer long-term benefits. LIFT should not be used as a first treatment in high trans-sphincteric fistula with perianal abscess.
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Metadata
Title
Lift and VAAFT for high trans-sphincteric anal fistula: a single center retrospective analysis
Authors
M. La Torre
G. Lisi
E. D’Agostino
M. Boccuzzi
M. Campanelli
M. Varriale
S. M. Tierno
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 6/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-020-03584-0

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