Abstract
Background: The operation of ligation of the fistulous tract in the intersphincter space (LIFT) is widely used in the world for transsphincter pararectal fistulas (TSPF). However, the frequency of fistula recurrence still cannot satisfy coloproctologists and dictates the need to modify the LIFT operation method in order to increase its reliability and safety.
 The aim: To present the modified LIFT technique and the results of its clinical application in the treatment of TSPF.
 Materials and methods: The LIFT operation modified by us (RF Patent No. 2686949) was performed in 40 patients with TSPF. The outcomes of the operation were evaluated according to the frequency of complications and recurrences of the fistula.
 Results: A distinctive feature of the developed modification of the LIFT operation method is the maximum elimination of the possibility of developing a "complete" recurrence of the fistula, since even if the bandaged and removed through the skin incision in the projection of the intersphincteric groove of the proximal stump of the fistulous tract, only a "small" recurrence can form, which is not dangerous and easy eliminate. All 40 patients did not have "complete" relapses within 9 to 18 months; "Small" recurrences in the posterior localization of fistulas developed in 2 (5 %) patients, in whom the fistula was dissected into the lumen of the rectum at the second stage, recovery occurred.
 Conclusions: The modification of the LIFT operation method proposed by us is a reproducible, accessible to coloproctologists, a safe and effective method of operation. Having a sphincter-preserving character character, the modified LIFT method makes it possible to avoid a "complete" recurrence of a fistula with a high probability, and with a low frequency of a "small" recurrence of a fistula, it makes it possible to safely eliminate a "small" recurrence of a fistula at the second stage, even on an outpatient clinic.
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