Abstract

Introduction: Ligation of the Intersphincteric Fistula Tract (LIFT) is a leading sphincter-sparing technique for complex anal fistulas. However, reported success rates vary widely, and factors influencing surgical outcomes remain debated.

Objectives: To investigate the clinical and imaging characteristics of complex anal fistulas and to evaluate surgical outcomes and analyze prognostic factors affecting the success rate of the LIFT procedure.

Methods: A prospective descriptive interventional study was conducted on 91 patients diagnosed with complex anal fistula treated with LIFT at Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital from December 2021 to December 2023.

Results: The majority of patients were male (89.0%) with a mean age of 39.1 ± 11.9 years. Transsphincteric fistulas were predominant (95.6%). 54.9% of patients had a history of prior sphincter-cutting surgery. The primary healing rate was 79.1% (72/91 patients), with a mean healing time of 6 weeks. The failure/recurrence rate was 20.9%. The procedure was safe with no intraoperative complications and a low rate of early postoperative complications (5.5%). Statistically significant predictors of failure (p<0.05) included: history of prior sphincter intervention, active infection status (intersphincteric abscess, immature fistula tract intraoperatively, active tract on MRI).

Conclusion: The LIFT procedure is safe and effective for complex anal fistulas. Success depends primarily on local infection status and tissue quality.