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Session: ePoster: Benign Anorectal 5 (Mon8)

EP608 - Comparison of BioLIFT vs LIFT for the Treatment of Trans-Sphincteric Anal Fistula: a Systematic Review and Meta-Analysis

Monday, May 12, 2025
8:05 AM – 8:10 AM PT
Location: Monitor 2, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Hilalion (San) Ahn, MD, FRCSC

    Clinical Fellow
    University of Toronto
    Toronto, ON, Canada

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

    • Author(s)

  • RH

    Richard Hu, Dr.

    Resident
    University of Ottawa
    Ottawa, ON, Canada

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

  • MC

    Mohamad Chahrour, MD

    Resident
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

  • LW

    Lara Williams, MD, MSc

    Colorectal Surgeon
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

  • IR

    Isabelle Raiche, MDCM, MEd

    Colorectal Surgeon
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

  • RB

    Robin Boushey, MD, PhD, CIP, FRCSC

    Colorectal Surgeon
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

  • MF

    Martin Friedlich, MD, MEd, FRCSC

    Colorectal Surgeon
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

  • Husein Moloo, MD, MSc (Epi) (he/him/his)

    Colorectal Surgeon
    University of Ottawa
    University of Ottawa
    Ottawa, Ontario, Canada

    Disclosure information not submitted.

    • Senior Author(s)

  • RM

    Reilly Musselman, MD, MSc, FRCSC

    Attending
    Queensway- Carleton Hospital
    Ottawa, Ontario, Canada

    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.
Hilalion (San) Ahn, MD, FRCSC: This individual has no financial relationships with ineligible companies.
Richard Hu, Dr.: This individual has no financial relationships with ineligible companies.
Reilly Musselman, MD, MSc, FRCSC: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure that treats transsphincteric fistulas while maintaining continence with reported healing rates of 40-95%. The BioLIFT is an augmentation of the LIFT with an intersphincteric bioprosthetic mesh and has reported healing rates between 69-94%. Despite increased costs and potential complications associated with mesh, the evidence comparing healing rates between BioLIFT and LIFT is unknown. The aim of this study was to perform a systematic review and meta-analysis of the healing and complication rates of fistulas treated with BioLIFT vs LIFT.

Methods/Interventions: Various databases were searched from inception to February 2022 using PRESS standards. Any comparative studies assessing adult patients undergoing BioLIFT or LIFT for transsphincteric anal fistula were included. Three reviewers performed abstract screening, full text review, and data extraction independently and in duplicate. A meta-analysis was performed using a random-effects inverse variance model. Outcomes included primary and secondary healing rate and complication rate.

Results/Outcomes: Of 528 citations screened, 3 studies (n=293) were included. All were retrospective cohort studies published in 2019-2020. All assessed cryptoglandular transsphincteric fistulas. Baseline characteristics were similar - of 65 patients who underwent BioLIFT, 66% were male, 28% had previous procedure for fistula, and 14% had history of smoking, diabetes, or immunosuppression, compared to 66%, 39% and 11%, respectively, in 228 patients who underwent LIFT. Meta-analysis revealed no significant impact of BioLIFT compared to LIFT on primary healing rate (OR 0.83, 95%CI [0.23-2.94], 3 studies, n=197), secondary healing rate (OR 0.97, 95%CI [0.26-3.69], 3 studies, n=237), and complication rate (OR 1.47, 95%CI [0.65-3.34], 2 studies, n=31).

Conclusion/Discussion: BioLIFT may not have a significant effect on primary and secondary healing and complication rates for cryptoglandular transsphincteric anal fistulas compared to LIFT. Results should be interpreted cautiously given the small number of studies and sample sizes