Abstract
Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital. A two-sided prosthesis piece bent in the shape of a cone is used here as an anal plug. The aim of this work was to evaluate the therapeutic results and the safety of this device. Patients and Methods: The clinical data of patients operated by the LIFT-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively. The variables evaluated were operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was 1.15. No patient presented preoperative continence disorder. The fistula was high trans-sphincteric in 89.3% of cases. The average duration of surgery was 55.2 minutes (45 to 66 minutes). The postoperative course was straightforward, although 60.7% of the patients had experienced tingling that resolved spontaneously. Three patients (10.7%) presented with transient gas incontinence (WIS of 4) which completely resolved after one month. All patients healed within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective technique for the treatment of upper anal fistula without major impairment of continence despite delayed healing. The adapted two-sided prosthesis is a good alternative to the conventional anal plug.
Highlights
Anal fistula is characterized by an abnormal communication between the anal canal and the surrounding perineal skin with a permanent purulent or faecal discharge and pain that impairs the patient’s quality of life
Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital
Patients and Methods: The clinical data of patients operated by the ligation of intersphincteric fistula tract (LIFT)-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively
Summary
Anal fistula is characterized by an abnormal communication between the anal canal and the surrounding perineal skin with a permanent purulent or faecal discharge and pain that impairs the patient’s quality of life. Fistulotomy and fistulectomy are historical techniques that have shown high cure rates They require varying degrees of sphincter transection, putting the patient at high risk of incontinence [1] [2] [3] [4] [5] and preservation of continence often requires multiple operations or the use of sphincter-sparing techniques [6]. These include fibrin sealant injection, anal plug and ligation of intersphincteric fistula tract (LIFT). The adapted two-sided prosthesis is a good alternative to the conventional anal plug
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