Annals of Coloproctology

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Original Article

Anorectal benign disease

Ligation of the intersphincteric fistula tract (LIFT) for high transsphincteric fistulas: a double-center retrospective study with long-term follow-up: Leichang Zhang, Chuanyu Zhan, Lu Li, Wanjin Shao, Guidong Sun, Yugen Chen, Guanghua Chen, Yulei Lang, Zenghua Xiao, Xiao Xiao; Ann Coloproctol. 2025;41(1):77-83. Published online January 17, 2025; DOI: https://doi.org/10.3393/ac.2024.00024.0003

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Purpose
This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas.
Methods
We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023.
Results
All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05).
Conclusion
LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Citations

Citations to this article as recorded by

Ligation of the intersphincteric fistula tract vs conventional surgery for anal fistula in Chinese patients
Xue Li, Cong-Cong Zhi, Xiao-Long Wang, Li-Hua Zheng, Yi-Cheng Cheng
World Journal of Gastrointestinal Surgery.2026;[Epub] CrossRef
Displaced lateral rectal flap for anal fistulas
Timur V. Nikishin, Ivan V. Kostarev, Alexander Yu. Titov, Maria A. Ignatenko, Evgeny E. Zharkov, Ikromzhon I. Dadashev, Oleg M. Biryukov, Anastasia E. Pershina, Andrey А. Mudrov
Koloproktologia.2026; 25(1): 71. CrossRef
A Comparative Study of Ligation of the Intersphincteric Fistula Tract versus Fistulotomy in Patients of Trans-sphincteric and Suprasphincteric Perianal Fistula
Charu Kant Singh, Arshad Ahmad, Abhinav Arun Sonkar
Indian Journal of Colo-Rectal Surgery.2025; 8(3): 91. CrossRef

Case Report

A Rare Case of Posterior Horseshoe Abscess Extending to Anterolateral Extraperitoneal Compartment: Anatomical and Technical Considerations: Christianna Oikonomou, Periklis Alepas, Stelios Gavriil, Dimitrios Kalliouris, Konstantinos Manesis, Petros Bouboulis, Dimitrios Filippou, Panagiotis Skandalakis; Ann Coloproctol. 2019;35(4):216-220. Published online May 31, 2019; DOI: https://doi.org/10.3393/ac.2018.03.05

14,406 View
193 Download
6 Web of Science
10 Citations

Abstract PDF

Perianal abscess and fistula are 2 distinct entities that share a common pathology. A horseshoe fistulous abscess, a complex type of these conditions, occurs when the suppurative inflammation spreads through the deep anal space to the bilateral ischiorectal fossae. Following the intersphincteric plane, this infection may extend to the pararectal space, forming a supralevator abscess. We present a very rare case involving a 52-year-old male patient who was admitted to our surgical department with an extraperitoneal purulent inflammation as a complication following multiple drainage procedures for a posterior horseshoe abscess. Emphasis is given to the anatomical and technical considerations of eradication of anorectal sepsis and the management of complex fistula-in-ano along with a concise review of the literature.

Citations

Citations to this article as recorded by

Acquired Ano-Rectal Sinuses and Fistulas Involving Genito-Urinary Structures in Men: A Case Series
Abhraneel Das, Devesh Malik, Saurav S Bhadoria, Asmita Asmita
Cureus.2025;[Epub] CrossRef
Fused Ischiorectal Phlegmon with Pre- and Retroperitoneal Extension: Case Report and Narrative Literature Review
Laurențiu Augustus Barbu, Liviu Vasile, Liliana Cercelaru, Ionică-Daniel Vîlcea, Valeriu Șurlin, Stelian-Stefaniță Mogoantă, Gabriel Florin Răzvan Mogoș, Tiberiu Stefăniță Țenea Cojan, Nicolae-Dragoș Mărgăritescu
Journal of Clinical Medicine.2025; 14(14): 4959. CrossRef
Ischiorectal abscess with retroperitoneal extension: masquerading as an appendicular abscess
Kalyani Dnyaneshwar Aher, Minakshi Gadhire, Naman Jain, Prafulla Salunkhe
International Surgery Journal.2025; 12(10): 1886. CrossRef
Innovative dual-access surgical strategy for advanced pelvic Fournier’s gangrene: a retrospective study assessing combined suprapubic and transsacral debridement
Zhi-Min Liu, Guo-Zhong Xiao, Jie Huang, Xin Jin, Neng-Sheng Lai, Xing-Yang Wan, Hong-Cheng Lin
BMC Gastroenterology.2025;[Epub] CrossRef
Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report
Hsiang Teng, Po-Hsien Wu
Medicina.2024; 60(2): 293. CrossRef
Complex Tunneling Perirectal Abscess: Intra-abdominal and Extraperitoneal Extension of a Persistent Perirectal Abscess
Abenezer S Tedla, Harsh R Parikh, Savni Satoskar, Jigyasha Pradhan, Shailja Kataria, Vinayak S Gowda
Cureus.2024;[Epub] CrossRef
Practical application of the wound healing agent in the treatment of patients with acute paraproctitis
L. A. Lichman, S. E. Katorkin, P. S. Andreev, O. E. Davydova
Ambulatornaya khirurgiya = Ambulatory Surgery (Russia).2024; 21(2): 120. CrossRef
Autologous Platelet-Rich Plasma Injection and Platelet-Rich Fibrin Glue Insertion for the Treatment of Extensive Supralevator Anorectal Fistula: A Case Report
Amin Dalili, Daryoush Hamidi Alamdari, Alimohamad Dalili, Maryam Sarkardeh, Alireza Rezapanah, Nooshin Tafazoli
WORLD JOURNAL OF PLASTIC SURGERY.2023; 12(1): 58. CrossRef
Adölesanda vajene spontan drene olan anorektal apse: Olgu sunumu
Ali Ekber Hakalmaz, Ayşe Kalyoncu Uçar, Gonca Topuzlu Tekant, Yunus Söylet, Sinan Celayir
Turkish Journal of Pediatric Surgery.2023; 37(3): 119. CrossRef
Extraperitoneal Spread of Anorectal Abscess: A Case Report and Literature Review
Papadopoulos S. Konstantinos, Dimopoulos Andreas, Kordeni Kleoniki, Filis Dimitrios
Annals of Coloproctology.2021; 37(Suppl 1): S11. CrossRef

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