Factors Affecting Long-term Recurrence and complications after Ligation of Intersphincteric Fistula Tract (LIFT) Procedure for Anal Fistula

Anorectal fistula resulted from the obstruction and infection of anorectal cryptoglandular glands is a common surgical entity. Although a number of treatment modalities have been proposed for this condition, recurrence rate is still high. In this study, long-term outcomes and complications of the LIFT (Ligation of Intersphincteric Fistula Tract) procedure were assessed in patients with anal fistula. This study is largest study with largest number of patients and longest follow up period in Iran and Middle East. In this prospective analytic clinical study, 50 patients with anal fistula referred to a tertiary colorectal clinic and underwent LIFT operation were enrolled from 2012 to 2017 and the patients were followed up for at least one year after the operation for any complication or recurrence. Outcomes and complications of the LIFT procedure as well as contributing factors were determined. A total of 50 patients studied in this study, including 43 males (86%) and 14 females (24%). Mean age of patients was 51.84±9.7 years and patients we followed up for a mean of 3.5±1.2 years after the operation. There were 12 recurrent cases and 32 cases with complications including 18 abscess/ infection and 14 gas incontinence. 71.4% of females and 25.6% of male subjects revealed complications showing significant difference (p<0.05). Longer time passed from the surgery, led to more recurrence (p<0.05). Other factors showed no significant association with recurrence and complications (p>0.05). In general, according to our results, it can be concluded that LIFT is an effective procedure in patients with anal fistula. Gender is a predicting factor for postoperative complication and the time passed from last surgery is the contributing factor for recurrence.