EP923 - Which Technique, LIFT or FIPS, Is More Effective for Low Transphincteric Fistula-in-Ano?

Tuesday, May 13, 2025

8:43 AM – 8:48 AM PT

ePoster Presenter(s)

Treerat Tangpulphon, MD.

Colorectal fellow
Colorectal Surgery Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Bangkok, Krung Thep, Thailand

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

JP

Jirawat Pattana-arun, MD.

Associate Professor
Colorectal Surgery Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Bangkok, Krung Thep, Thailand

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Treerat Tangpulphon, MD.: This individual has no financial relationships with ineligible companies.

Jirawat Pattana-arun, MD.: This individual has no financial relationships with ineligible companies.

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Purpose/Background:

Background: There are several treatment options for low transphincteric fistula, but no single approach has been established as the best choice. The ligation of the intersphincteric fistula tract (LIFT) technique is known for preserving sphincter function and demonstrating good healing outcomes. Fistulotomy or fistulectomy with immediate primary sphincteroplasty (FIPS) is increasingly used for simpler fistulas. However, no studies have compared the outcomes of these two surgical approaches specifically for low transphincteric fistula-in-ano.

Objective: This study aimed to compare the surgical outcomes between LIFT and FIPS in the treatment of low transphincteric fistula-in-ano.

Methods/Interventions:

Methods: A retrospective study was conducted, including all patients with low transphincteric fistula-in-ano who underwent LIFT and FIPS procedures between January 2019 and December 2023 in King Chulalongkorn Memorial Hospital, Thailand. Outcome measures included fistula healing rate, healing time, recurrence rate, and incontinence status.

Results/Outcomes:

Results: A total of 88 patients were included in the study, with 40 patients in the LIFT group and 48 in the FIPS group. There were no significant differences in baseline characteristics such as age, sex, BMI, or underlying diseases. The mean follow-up period was 10 months. The healing rate was 89.6% for the FIPS group and 80.0% for the LIFT group (p=0.207). The median healing time was 39 days (range: 22-62) for FIPS and 70 days (range: 52-90) for LIFT. Recurrence rates were 97.8% for FIPS and 88.9% for LIFT (p=0.099). There were no significant differences in wound infection or wound dehiscence between the two groups. The gas incontinence rate was 89.6% in the FIPS group, while no incontinence was reported in the LIFT group. Moreover, the operative time for FIPS was 37.94 ± 16.78 minutes, compared to 63.52 ± 25.44 minutes for LIFT.

Conclusion/Discussion:

Conclusions: Both LIFT and FIPS procedures demonstrated comparable healing rates and recurrence rates in the treatment of low transphincteric fistula-in-ano, with no statistically significant difference in wound infection and dehiscence between 2 groups. However, FIPS had a shorter operative time and healing time but a higher rate of gas incontinence, while LIFT showed a longer healing time with no reported incontinence.