scholarly journals Systematic review and meta‐analysis of endorectal advancement flap and ligation of the intersphincteric fistula tract for cryptoglandular and Crohn's high perianal fistulas

BJS Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 166-167
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Perianal Fistulas ◽  
Endorectal Advancement Flap ◽  
Intersphincteric Fistula

scholarly journals Systematic review and meta‐analysis of endorectal advancement flap and ligation of the intersphincteric fistula tract for cryptoglandular and Crohn's high perianal fistulas

BJS Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 231-241 ◽  
Author(s):  
M. E. Stellingwerf ◽  
E. M. van Praag ◽  
P. J. Tozer ◽  
W. A. Bemelman ◽  
C. J. Buskens
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Perianal Fistulas ◽  
Endorectal Advancement Flap ◽  
Intersphincteric Fistula

scholarly journals P426 Meta-analysis of endorectal advancement flap vs. ligation of the intersphincteric fistula tract for Crohn’s and cryptoglandular high perianal fistulas

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S320-S320 ◽  
Author(s):  
M E Stellingwerf ◽  
E M van Praag ◽  
W A Bemelman ◽  
C J Buskens
Keyword(s):  
Meta Analysis ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Perianal Fistulas ◽  
Endorectal Advancement Flap ◽  
Intersphincteric Fistula

scholarly journals The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Carlos Placer-Galán ◽  
Jose Mª Enriquez-Navascués ◽  
Tania Pastor-Bonel ◽  
Ignacio Aguirre-Allende ◽  
Yolanda Saralegui-Ansorena
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Cochrane Library ◽  
Fistula In Ano ◽  
Intersphincteric Fistula ◽  
The Impact ◽  
Seton Placement ◽  
Primary Healing

Abstract Background There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design systematic review and meta-analysis. Data Sources A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results Ten studies met the criteria for systematic review, all retrospective, with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73–1.43: p = 0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27–42.7%), recurrence with the use of seton was 40% (IQR 26.6–51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3–51.3%) Limitations The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement.International prospective register of systematic reviews—PROSPERO registration number: CDR42020149173.

scholarly journals Ligation of the Intersphincteric Fistula Tract and Endorectal Advancement Flap for High Perianal Fistulas in Crohn’s Disease: A Retrospective Cohort Study

2019 ◽  
Vol 14 (6) ◽  
pp. 757-763 ◽  
Author(s):  
Elise M van Praag ◽  
Merel E Stellingwerf ◽  
Jarmila D W van der Bilt ◽  
Wilhelmus A Bemelman ◽  
Krisztina B Gecse ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Recurrence Rates ◽  
Perianal Fistulas ◽  
Radiological Healing ◽  
Intersphincteric Fistula ◽  
Clinical Healing ◽  
Postoperative Incontinence

Abstract Background and Aims Ligation of the intersphincteric fistula tract [LIFT] and advancement flap [AF] procedures are well-established, sphincter-preserving procedures for closure of high perianal fistulas. As surgical fistula closure is not commonly offered in Crohn’s disease patients, long-term data are limited. This study aims to evaluate outcomes after LIFT and AF in Crohn’s high perianal fistulas. Methods All consecutive Crohn’s disease patients ≥18 years old treated with LIFT or AF between January 2007 and February 2018 were included. The primary outcome was clinical healing and secondary outcomes included radiological healing, recurrence, postoperative incontinence and Vaizey Incontinence Score. Results Forty procedures in 37 patients [LIFT: 19, AF: 21, 35.1% male] were included. A non-significant trend was seen towards higher clinical healing percentages after LIFT compared to AF [89.5% vs 60.0%; p = 0.065]. Overall radiological healing rates were lower for both approaches [LIFT 52.6% and AF 47.6%]. Recurrence rates were comparable: 21.1% and 19.0%, respectively. In AF a trend was seen towards higher clinical healing percentages when treated with anti-tumour necrosis factor/immunomodulators [75.0% vs 37.5%; p = 0.104]. Newly developed postoperative incontinence occurred in 15.8% after LIFT and 21.4% after AF. Interestingly, 47.4% of patients had a postoperatively improved Vaizey Score [LIFT: 52.9% and AF: 42.9%]. The mean Vaizey Score decreased from 6.8 [SD 4.8] preoperatively to 5.3 [SD 5.0] postoperatively [p = 0.067]. Conclusions Both LIFT and AF resulted in satisfactory closure rates in Crohn’s high perianal fistulas. However, a discrepancy between clinical and radiological healing rates was found. Furthermore, almost half of the patients benefitted from surgical intervention with respect to continence.

Treatment of Refractory Perianal Fistulas with Ligation of the Intersphincteric Fistula Tract: Preliminary Results

2013 ◽  
Vol 79 (7) ◽  
pp. 723-727 ◽  
Author(s):  
Michael L. Campbell ◽  
Elia Charbel Abboud ◽  
Michael E. Dolberg ◽  
Jaime E. Sanchez ◽  
Jorge E. Marcet ◽  
...  
Keyword(s):  
Success Rate ◽  
Anal Fistula ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Success Rates ◽  
End Points ◽  
Perianal Fistulas ◽  
Fistula Plug ◽  
Variable Success ◽  
Intersphincteric Fistula

Several surgical options exist for management of fistula in ano. The goal of treatment is to achieve closure of the fistula while maintaining continence. Sphincter-sparing operations to close perianal fistulas include advancement flap, anal fistula plug, fibrin glue, and fistulectomy. Variable success rates from 30 to 80 per cent have been reported. Ligation of intersphincteric fistula tract (LIFT), first described in 2007, has a reported success rate from 40 to 94 per cent. The objective of this study was to study our results of the LIFT procedure for refractory perianal fistulas. We conducted a retrospective 18-month review of consecutive patients with refractory perianal disease treated with the LIFT procedure at an academic, tertiary, colorectal practice. All patients undergoing a LIFT procedure for anal fistula from August 2010 to August 2012 were included in the study. The primary end points were success rates at 1 month and 3 months. Secondary end points were postoperative complications and maintenance of continence. Twenty patients underwent LIFT procedures of whom nine had previously failed treatments. Mean age was 45 years and included 12 male and eight female patients. Success rate at 1 month was 70 per cent (14 patients) and at 3 months was 80 per cent (16 patients). Success rates for patients with previously failed attempts were 67 per cent at 1 month and 89 per cent at 3 months. Continence was maintained in 100 per cent of patients. Our data support the use of the LIFT procedure for refractory perirectal fistulas.

Ligation of intersphincteric fistula tract (LIFT) in treatment of anal fistula: An updated systematic review, meta-analysis, and meta-regression of the predictors of failure

Surgery ◽  
2020 ◽  
Vol 167 (2) ◽  
pp. 484-492 ◽  
Author(s):  
Sameh Hany Emile ◽  
Sualeh Muslim Khan ◽  
Adeyinka Adejumo ◽  
Oyintonbra Koroye
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Intersphincteric Fistula ◽  
Meta Regression

Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula: systematic review and meta-analysis

2014 ◽  
Vol 18 (8) ◽  
pp. 685-691 ◽  
Author(s):  
K. D. Hong ◽  
S. Kang ◽  
S. Kalaskar ◽  
S. D. Wexner
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Intersphincteric Fistula

Tu1763 Results of Ligation of Intersphincteric Fistula Tract and Advancement Flap for Treatment of Complex Transsphincteric Anal Fistula: Anatomy of the Recurrence

2015 ◽  
Vol 148 (4) ◽  
pp. S-1176
Author(s):  
Darcy Shaw ◽  
Charles Ternent ◽  
Sean Langenfeld ◽  
Garnet Blatchford ◽  
Jennifer S. Beaty ◽  
...  
Keyword(s):  
Anal Fistula ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Intersphincteric Fistula

Ligation of Intersphincteric Fistula Tract Versus Mucosal Advancement Flap in Patients With High Transsphincteric Fistula-in-Ano

2014 ◽  
Vol 57 (10) ◽  
pp. 1202-1208 ◽  
Author(s):  
Khaled M. Madbouly ◽  
Walid El Shazly ◽  
Khaled S. Abbas ◽  
Ahmed M. Hussein
Keyword(s):  
Advancement Flap ◽  
Fistula Tract ◽  
Transsphincteric Fistula ◽  
Fistula In Ano ◽  
Intersphincteric Fistula
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