Results from a novel modification to the ligation intersphincteric fistula tract

Background The ligation of intersphincteric fistula tract (LIFT) procedure for trans-sphincteric fistula-in-ano has been studied with variable success rates compared with initial reports. Failures occur mostly in the intersphincteric wound. Recently, we proposed a modification to LIFT, unroofing the fistula from internal opening to intersphincteric groove, ligating the fistula tract, but preserving the external sphincter. Methods This retrospective review assesses outcomes of patients undergoing the modified LIFT for trans-sphincteric fistulae. Results Sixty-six modified LIFT procedures were performed. The main cohort consisted of 56 patients, predominantly men (76.7%). Median operative time was 16 minutes. Median follow-up was 20.98 weeks. Overall cure rate was 71.42%, with a recurrence rate of 5.35% and fistula persistence in 16.07%. There was no persistent fecal incontinence. Conclusion Modified LIFT is a safe procedure that is easily performed, has short operative time, eliminates the intersphincteric space, and has cure rates equal to or better than the original LIFT.