SP 8.11 Clinical Outcomes of the Ligation of Intersphincteric Fistula Tract (LIFT) Procedure for Anal Fistulas: A Single-Centre Study

Abstract

Anal fistulas, particularly intersphincteric and transsphincteric types, are surgically challenging due to the need to preserve anal sphincter function. The ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving technique, though real-world outcome data remain limited.

Methods: A single-centre retrospective case series was conducted at a tertiary referral centre in the United Kingdom. Adult patients (≥18 years) with intersphincteric or transsphincteric anal fistulas undergoing the LIFT procedure were included between October2024 and April 2025, with follow-up extending to October 2025.Data collected included patient demographics, fistula characteristics, operative details, and postoperative outcomes. Fistulas were categorised as simple or complex based on predefined criteria. The primary outcome was successful fistula healing without recurrence. Secondary outcomes included postoperative complications, recurrence, need for re-intervention, and continence outcomes assessed clinically and quantified using the Vaizey incontinence score when symptoms were reported.

Results: Twenty-one patients were included, with a median age of 43 years (range21–62);12 (57%) were male and nine (43%) female. Seven patients (33%) had complex fistulas. The mean operative time was 50 minutes, and the mean postoperative length of stay was 1± 0.5 days. Over a median follow-up of 10 months (range2–12 months), fistula recurrence occurred in two patients (9.2%), one from each fistula group. One patient (4.7%) developed a postoperative wound infection, managed conservatively. Transient continence disturbance occurred in three patients (14%), all resolving within two months. No permanent incontinence or major complications were observed.

Conclusion: The LIFT procedure is a safe and effective sphincter-preserving option for intersphincteric and transsphincteric anal fistulas, with low recurrence rates and minimal impact on continence.