Modified LIFT via a Lateral Approach Versus Standard LIFT for Transsphincteric Anal Fistula: A Prospective Randomized Study.
Tuğberk Tok, Yusuf Sevim
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In 30 seconds
This single-center prospective randomized study compared modified ligation of the intersphincteric fistula tract (LIFT) via a lateral approach with standard LIFT in adults with MRI-confirmed transsphincteric anal fistula. Forty patients were randomized equally and followed for 12 weeks. Median wound healing time was shorter with modified LIFT: 13 days (interquartile range, 10-17) versus 29.5 days (26-32) with standard LIFT (p < 0.001). Early recurrence or persistence was also less frequent in the modified group, while pain scores were comparable and neither group had observed fecal incontinence.
Key findings
- Median wound healing time was 13 days (interquartile range, 10-17) with modified LIFT versus 29.5 days (26-32) with standard LIFT (p < 0.001).
- By week 12, recurrence or persistence occurred in 6 of 20 standard LIFT patients (30.0%) and none of the modified LIFT patients (Fisher exact test; p = 0.020).
- Pain scores were low and comparable at weeks 1 and 4; no fecal incontinence was observed in either group during follow-up.
Why it matters
The findings suggest that the lateral-approach modification may improve early healing and reduce short-term treatment failure without an observed penalty in pain or continence. These outcomes are clinically relevant when assessing fistula procedures, but the results describe a small, selected group and only early follow-up, so they do not establish comparative long-term effectiveness.
What to keep in mind
The single-center study analyzed 40 patients and followed them for only 12 weeks; the authors state that larger studies with longer follow-up are needed to assess long-term recurrence.