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Session: ePoster: Benign Anorectal 6 (Mon1015)

EP686 - 15-Year Single-Center Study on Recurrence Risk Factors After LIFT Procedure for Anal Fistula

Monday, May 12, 2025
10:20 AM – 10:25 AM PT

    ePoster Presenter(s)

  • WITCHA VIPUDHAMORN (he/him/his)

    Surgeon
    Division of Colorectal Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
    Chiangmai, Chiang Mai, Thailand

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

    • Author(s)

  • PS

    PAWIT SUTHARAT, n/a

    Head of colorectal surgery unit, Chiangmai university
    Division of Colorectal Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
    Chiangmai, Chiang Mai, Thailand

    Disclosure information not submitted.

  • SS

    SUWAN SANMEE, n/a

    Colorectal surgeon, Chiangmai university
    Division of Colorectal Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
    Chiangmai, Chiang Mai, Thailand

    Disclosure information not submitted.

    • Senior Author(s)

  • ES

    EKKARIN SUPATRAKUL, n/a

    Colorectal surgeon, Chiangmai university
    Division of Colorectal Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
    Chiangmai, Chiang Mai, 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.
WITCHA VIPUDHAMORN: This individual has no financial relationships with ineligible companies.
EKKARIN SUPATRAKUL, n/a: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Anal fistula is a challenging condition to treat, characterized by abnormal connections that often require surgical intervention. The ligation of the intersphincteric fistula tract (LIFT) procedure is a sphincter-preserving technique aimed at reducing recurrence and minimizing the risk of incontinence. Despite variable success rates, long-term recurrence remains a concern, and understanding risk factors could help in improving treatment outcomes. This study investigates the potential risk factors influencing recurrence after the LIFT procedure over a 15-year period.

Methods/Interventions: This retrospective cohort study reviewed records of patients aged 20-80 years who underwent the LIFT procedure for cryptoglandular anal fistula at Chiang Mai University Hospital between 2007 and 2022. Criteria included exclusion of those with underlying colorectal or pelvic cancer and inflammatory bowel disease. Recurrence was defined as the opening of a fistula that persisted after 3 months.

Results/Outcomes: Out of 142 patients, 35.2% experienced recurrence within a median follow-up period of 40 months. Several key factors were strongly significantly associated with recurrence. These include engaging in prolonged sitting activities (adjusted hazard ratio [HR] 8.07, p=0.002), a factor not extensively analyzed in previous studies focusing on LIFT procedure failures. Other significant factors were a high Wexner constipation score (adjusted HR 1.21, p=0.024), an internal opening height of ≥15 mm (adjusted HR 5.92, p=0.005), and an external opening distance from the anal verge of ≥5 mm (adjusted HR 3.02, p=0.049).

Conclusion/Discussion: The study identifies long-sitting activities, high constipation scores, and specific anatomical features as key risk factors for fistula recurrence following the LIFT procedure. These findings suggest that a multifaceted approach, incorporating lifestyle modification and careful patient selection based on anatomical characteristics, may enhance the long-term success of the LIFT procedure.