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

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

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 < 0.05).

Conclusions

Both techniques are safe and effective and can offer long-term benefits. LIFT should not be used as a first treatment in high trans-sphincteric fistula with perianal abscess.

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Acknowledgements

La Torre M: acquisition data.

Lisi G: interpretation of data, statistical analysis, critical review, drafting and manuscript preparation.

Campanelli M: data repository.

Boccuzzi M and D’Agostino E: supervising.

Tierno SM: acquisition data.

Varriale M: acquisition data.

Author information

Authors and Affiliations

  1. Department of Surgery, UPMC University of Pittsburgh Medical Center (Salvator Mundi International Hospital) and Villa Tiberia Hospital, Rome, Italy

    M. La Torre

  2. Department of General Surgery, Coloproctology and Pelvic Floor Disease Unit, San Sebastiano Martire Hospital, Frascati, Italy

    G. Lisi, E. D’Agostino & M. Boccuzzi

  3. Minimally Invasive Surgery Unit, University of Tor Vergata, Rome, Italy

    M. Campanelli

  4. Department of Surgery, Ospedale Sandro Pertini, Rome, Italy

    M. Varriale

  5. Department of Surgery, Ospedale GM Vannini, Istituto Figlie di San Camillo, Rome, Italy

    S. M. Tierno

Authors
  1. M. La Torre
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  2. G. Lisi
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  3. E. D’Agostino
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  4. M. Boccuzzi
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  5. M. Campanelli
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  6. M. Varriale
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  7. S. M. Tierno
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Correspondence to G. Lisi.

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La Torre, M., Lisi, G., D’Agostino, E. et al. Lift and VAAFT for high trans-sphincteric anal fistula: a single center retrospective analysis. Int J Colorectal Dis 35, 1149–1153 (2020). https://doi.org/10.1007/s00384-020-03584-0

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  • DOI: https://doi.org/10.1007/s00384-020-03584-0

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