| Background:Anal fistula is a common disease in anorectal surgery. Surgery is the only effective method to cure anal fistula. Both the fistulotomy and cutting seton may lead to fecal incontinence. Is there any surgery not only protect anal function, but also cure the disease? As one of the sphincter-sparing methods, ligation of the intersphicteric fistula tract (LIFT) can maximally protect anal function. At the same time, it also has a high cure rate. Nowadays, it is becoming a hot spot in recent research. Up to now, there are no large samples of randomized clinical trials (RCT) in China to determine the meaning of LIFT.Object:Researching the effect of LIFT in transsphincteric fistula.Methods:132 surgical patients from four research centers are divided into treatment group (LIFT) and control group (fistulotomy or cutting seton) according to random number table. There are 67 patients in treatment group and 65 patients in control group. Observation indexes include operative time, postoperative pain, wound healing time, preoperative and postoperative anal control ability, postoperative anal morphology change, clinical cure rate and recurrence rate.Results:Compared with control group, the patients in treatment group have light operative pain on the 7th、14th postoperative day, shorter wound healing time and better postoperative anal control ability. The cure rate of treatment group is 86.57% and the control group is 93.85%. There is no difference in the cure rate between two groups.Conclusion:Through the large samples of randomized controlled clinical trial and a long time follow-up, we discover that as one of the sphincter-sparing methods, LIFT has many advantages, such as high cure rate, light operative pain, shorter wound healing time and better postoperative anal control ability. Through several improvement of operation methods, we reduce the postoperative complications, such as infection and disruption of wound, and improve the clinical effects. |
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