Perianal Fistulotomy

Discussion:
The goal of surgical management for perianal fistula is to effectively eradicate current and recurrent septic foci, associated epithelialized tracts and preserve continence. No single technique achieves these aims for all types of anal fistulas. It is often necessary to balance the degree of sphincter division and continence disturbance. An ideal procedure for treating a fistula-in-ano should be minimally invasive with minimal failure rates and morbidity. 12
Based on the data available from the meta-analysis studies published by of Vergara-Fernandez and coworker (2013)21, Murugesan and coworkers (2014)12, Hong and coworkers (2014)9, who had gathered most of the published clinical trials on the LIFT technique, and also based on
13 Our study is a randomized control study comparing LIFT procedure to fistulotomy and Seton insertion as gold slandered for the treatments of the perianal fistula.
This study was performed on 31 patients with perianal fistula. Many studies performed on the LIFT technique were performed with the figures near to this figure; like that of Ellis (2010)5 who also recruited the same number of patients, and that of Han and coworkers (2012)7 and Lu and coworkers (2013)10 who recruited 38 patients for each of their studies.
We followed-up patient participated in our study for a period ranged from 8 to 13months with a mean of 10.5 months. Murugesan and coworkers (2014)12 found that the follow- up range in the studies collected for their meta-analysis was 0–67 months, but they didn’t calculate the mean for the follow-up periods. In reviewing their data, a single study only had this lengthy follow-up period of 67 months, it was for Tan and coworkers (2012)19, and was a retrospective study, and this may explain the cause of lengthy follow-up period. Most of the prospective studies choose a follow-up period less than 12 months, for fear of attrition, especially when the condition is completely
Ellis CN. Outcomes with the use of bioprosthetic grafts to reinforce the ligation of the inter-sphincteric fistula tract (Bio- LIFT procedure) for the management of complex anal fistu- las. Dis Colon Rectum 2010; 53: 1361-1364
6. Hamalainen KP, Sainio AP. The incidence of fistulas after drainage of acute anorectal abscesses. Dis Colon Rectum. Nov 1998; 41 (11): 1357-61; discussion 1361-2.
7. Han JG, Yi BQ, Wang ZJ, et al. Ligation of the intersphincteric fistula tract plus a bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano. Color Dis. 2013;15(5):582-586.
8. Hancock BD. ABC of colorectal diseases. Anal fissures and fistulas. BMJ. Apr 4 1992;304 (6831): 904-7.
9. Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12.
10. Liu WY, Aboulian A, Kaji AH, Kumar RR. Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula- in-ano. Dis Colon Rectum 2013; 56: 343-347.
11. Matos D, Lunniss PJ, Phillips RKS Total sphincter conservation in high fistula in ano: results of a new approach. Br J Surg 1993