Multi Center Analysis Of Intersphincteric Fistula Ligation Failure Factors

BACKGROUND:LIFT is a kind of all keep sphincter surgery for the treatment of anal fistula.Because of its guarantee the integrity of the sphincter, postoperative anal function advantage such as less damage, postoperative incision healing faster gradually promoted by scholars at home and abroad.OBJECTIVE:The aim of this study was to evaluate the success rates and functional outcome after the ligation othe intersphincteric fistula tract procedure. Analysis of risk factors lead to LIFT surgery failure.SETTINGS:The study was conducted at Affiliated hospital of Nanjing University of Traditional Chinese Medicine, Suzhou hospital of Traditional Chinese Medicine and at Nanjing Hospital of traditional Chinese Medicine, between September 2009-December 2015.METHODS:The study included in September 2009 to December 2015, Jiangsu Province Hospital of traditional Chinese medicine, Nanjing Institute of traditional Chinese medicine, Suzhou City Hospital of traditional Chinese medicine anorectal of 76 routine LIFT surgery in the treatment of complicated sphincter fistula cases, Through follow-up,64 cases were cured, 12 cases of recurrence. Respectively, the age, sex, smoking, horseshoe fistula, operation times, fistula location, whether or not digging the tunnel except factors analysis, to explore the possible influence factors of affect the operation of the LIFT failure.MAIN OUTCOME MEASURES:Failure was defined as persistent or recurrent drainage, air leakage from a patent external opening, or intersphincteric incision or reoperation for recurrent fistula. Success was defined as healing of the external fistula opening and intersphincteric incision. Patients were followed up with a questionnaire to assess the recurrence rate and the CCF-FI incontinence score.RESULTS:A total of 76 cases, average age was 35.4 years (21-62 years), which male patients were 60 cases,16 cases for female patients,76 cases of smoking have 34 cases (44.7%),76 patients, which horseshoe fistula patients for 11 cases (14.5%). The duration of 6 months to 5 years (average 1.64 years), of which 22 cases (28.9%) in intersphincteric fistula ligation before have the history of anal fistula surgery.15 cases of postoperative emergence of intersphincteric infection,7 cases evolution my enteric fistula, incision of wound healing after discharge,8 cases during his stay in hospital after the silver ions dressing wound healing was discharged, the multicenter follow-up in 12 cases in different time recurrence,3 routine incision Seton after cure.1 cases were discharged on July after he relapsed in the hospital (specific and unspecified), the remaining 8 cases cured after incision of anal fistula. By statistical analysis, gender, age, smoking and other clinical data by statistical analysis, The relationship between smoking and incision infection,it is concluded that bilateral P=0.020<0.05,therefore, the difference statistically significant,The incision infection and recurrence were analyzed, P<0.01, with statistical significance. The infection of incision is a risk factor for recurrence.CONCLUSION:Lift surgery is a sphincter preserving operation, can cure the fistula, and ensure the integrity of the sphincter function and the multi center clinical study analysis found incision infection is lead to the impact factor of recurrence and look forward to late a large sample of clinical research.