Nisar A Chowdri1, Salim Nazki2*, Zamir Ahmad Shah3 and Gowhar Aziz Bhat4
1Department of General and Minimal Invasive Surgery and Colorectal Division, Sher-i-Kashmir Institute of Medical
Sciences Srinagar, India
2Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences Srinagar, India
3Department of Cardiovascular and Thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences Srinagar, India
4Department of Colorectal Surgery, Sher-i-Kashmir Institute of Medical Sciences Srinagar, India
Background: A sphincter saving technique known as Ligation of Intersphincteric Fistula Tract
(LIFT) has become popular for treatment of fistula-in-ano. This technique involves ligation and
division of the fistula tract in the intersphincteric space without using any biological material.
Aim: The aim of the study was to see the feasibility and results of LIFT technique in managing
different types of fistula-in-ano and the postoperative complications and recurrence rates.
Method: A prospective study conducted in the department of colorectal surgery, a division of
General and Minimal Invasive Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS)
Srinagar over a period of 26 months. Patients with fistula-in-ano were enrolled for the study.
Detailed history, clinical examination & evaluation were done as per the protocol. Patients were
subjected to standard surgical treatment. LIFT was used where found to be feasible depending on
type and nature of fistula. All patients were followed regularly and results analyzed statistically.
Results: The LIFT technique seems to be safe and simple but our study revealed that only 38.2%
cases of all Fistula-in-Ano could be treated by this technique. Procedure is difficult in patients
having horse shoe fistula, non-location of internal opening or tract, scarring due to previous surgery
multiple tracts, complex fistulas, abscesses, high fistula, curved and short tract. None of the patients
had post-operative incontinence however 6.4% had post-operative infection and 12.9% had wound
dehiscence. Recurrence was observed in only one patient. Most of the patients (77.41%) had less than
1 day stay in hospital post procedure. On satisfaction score, 67.74% patients who underwent LIFT
technique were satisfied and 22.58% were non-satisfied. The median follow up was 17.6 months.
Conclusion: The ligation of the intersphincteric fistula tract technique for fistula-in-ano surgery,
which aims at total anal sphincter preservation is safe and easy to perform but has its demerits too.
Further modifications are needed to treat the complex fistulae and fistulas having multiple tracts.
Chowdri NA, Nazki S, Shah ZA, Bhat GA. Ligation of Intersphincteric Fistula Tract (LIFT) For Fistula-in-Ano: Feasibility and Our Experience. World J Surg Surgical Res. 2020; 3: 1209..