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Updated: Mar 29, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Ligation of Intersphincteric Fistula Tract vs Ligation of the Intersphincteric Fistula Tract Plus a Bioprosthetic
Jia Gang Han1, Zhen Jun Wang, Yi Zheng
1*Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical Univerisity, Beijing, People's Republic of China†Department of General Surgery, Peking University Third Hosptial, Beijing, People's Republic of China‡Department of General Surgery, Shanxi Provincial People's Hospital, Shaanxi, People's Republic of China§Department of General Surgery, The First Affiliated Hospital of the School of Medicine Xi An Jiaotong University, Shaanxi, People's Republic of China¶Department of General Surgery, Tianjin Third Central Hospital, Tianjin, People's Republic of China.
Objective:
The purpose of this study was to compare the ligation of intersphincteric fistula tract (LIFT) with an additional plug (LIFT-plug) in the treatment of transsphincteric anal fistula.
Summary Background Data:
Both LIFT and LIFT-plug are recently reported effective alternatives of transsphincteric anal fistula.
Methods:
This multicenter prospective randomized study (NCT01478139) was conducted at 5 university hospitals throughout China. A total of 235 patients were randomly assigned to undergo LIFT (118 patients) or LIFT-plug (117 patients) between March 2011 and April 2013. The primary outcome measured was primary healing rate at 6 months postoperatively and healing time. Secondary outcomes included recurrence rate, postoperative pain, and incontinence rate.
Results:
The LIFT procedure showed shorter operative time than the LIFT-plug procedure (26.7 min vs 28.5 min, P = 0.03). Median healing time was 22 days in LIFT-plug group vs 30 days in LIFT group (P < 0.001). The difference in visual analog scale scores across all time points was not statistically significant between the groups (P = 0.13). The primary healing rate was higher in LIFT-plug group than in LIFT group [94.0% (95% confidence interval 89.7%-98.3%) vs 83.9% (95% confidence interval 77.2%-90.6%), P < 0.001]. There were no reported incontinence and recurrence within the follow-up period of 6 months.
Conclusions:
In patients with transsphincteric anal fistulas, both LIFT-plug and LIFT are simple, safe, and effective procedures. LIFT-plug has the advantage of a higher healing rate, less healing time, and a lower early postoperative pain score.
