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

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 patient...

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Bibliographic Details
Published in:International journal of colorectal disease 2020-06, Vol.35 (6), p.1149-1153
Main Authors: La Torre, M., Lisi, G., D’Agostino, E., Boccuzzi, M., Campanelli, M., Varriale, M., Tierno, S. M.
Format: Article
Language:English
Subjects:
Abscess - complications
Abscess - surgery
Abscesses
Anal Canal - physiopathology
Anal Canal - surgery
Anorectal
Anorectal fistula
Care and treatment
Comparative analysis
Cutaneous Fistula - complications
Cutaneous Fistula - surgery
Fecal incontinence
Fecal Incontinence - etiology
Fistula
Fistulae
Follow-Up Studies
Gastroenterology
Hepatology
Humans
Internal Medicine
Ligation
Manometry
Medicine
Medicine & Public Health
Metronidazole
Morbidity
Original Article
Pain, Postoperative - etiology
Patients
Proctology
Rectal Fistula - complications
Rectal Fistula - physiopathology
Rectal Fistula - surgery
Recurrence
Retrospective Studies
Surgery
Treatment Failure
Ultrasound
Video-Assisted Surgery
Wound Healing
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Summary: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  
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-020-03584-0