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Tech Coloproctol ; 15(4): 413-6, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22076690

RESUMO

BACKGROUND: Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique. METHODS: Between October 2010 and April 2011, 18 patients with 'complex' fistulas underwent LIFT. All patients were enrolled in the study after a physical examination including digital examination and proctoscopy. For the purpose of this pilot study, fistulas were classified as complex if any of the following conditions were present: tract crossing more than 30% of the external sphincter, anterior fistula in a woman, recurrent fistula or pre-existing incontinence. Endpoints were healing time, presence of recurrence, faecal incontinence and surgical complications. RESULTS: Ten patients were men and 8 were women; mean age was 39 years; minimum follow-up was 4 months. Three patients required drainage seton insertion and delayed LIFT. After LIFT, 1 patient experienced haemorrhoidal thrombosis. At the end of the follow-up, 15 patients (83%) healed with no recurrence. Three patients had persistent symptoms and required further surgical treatment. We did not observe postoperative worsening of continence. CONCLUSIONS: Results from our pilot study indicate that this novel sphincter-saving approach is effective and safe for treating complex anal fistula.


Assuntos
Canal Anal/cirurgia , Fístula Retal/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Proctoscopia , Estudos Prospectivos , Fístula Retal/diagnóstico , Prevenção Secundária , Técnicas de Sutura , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
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