Comparison Between Ligation of Intersphincteric Fistula Tract (LIFT)Technique and Conventional Fistulotomy in the Treatment of Fistula-in-Ano

Abstract

Objective: To compare the LIFT and traditional fistulotomy on the management of fistula-in-Ano with particular emphasis on the healing, recurrence of fistula, post-surgical pain, and anal sphincter functionality.

Study Design: Retrospective study
Place and Duration of Study: This study was conducted at the General Surgery Department, Sandeman Provincial Hospital / Bolan Medical Complex Hospital, Quetta from June 2025 to October 2025.

Methods: The retrospective study was done in a sample of 100 patients with fistula-in-ano who underwent either LIFT (n=50) or traditional fistulotomy (n=50) at a tertiary care hospital. The demographic information, fistula type, complications, postoperative pain ratings, and recurrences were recorded. The follow-up was done at 3, 6, and 12 months to measure the healing, recurrence, and preservation of the sphincter. SPSS was used to conduct statistical analysis, and p-values were used to evaluate the significance.

Results: The mean age of the patients was 38.2 ± 9.5 years. The LIFT group showed a healing rate of 90% with a 10% complication rate (mild infection). In contrast, the fistulotomy group had a 75% healing rate, with 25%
experiencing recurrence and incontinence. Postoperative pain was significantly lower in the LIFT group (mean score 3.2 ± 1.1) compared to fistulotomy (mean score 6.1 ± 2.4, p < 0.05). The recurrence rate was significantly lower in the LIFT group (10%) compared to the fistulotomy group (25%, p = 0.02).

Conclusion: The LIFT method had better results than the traditional fistulotomy on the treatment of fistula-in-ano, recurrence, postoperative pain, and sphincter preservation. A complex or high anal fistula is advised to undergo the LIFT procedure, and fistulotomy is effective in a simple one. The outcomes favor LIFT as a safer treatment and more effective.