Srinithya, A (2020) A Study on Sphincter Preserving Procedure Lift (Ligation of Intersphincteric Fistula Tract) in patients with Fistula in Ano in Government Stanley Medical College. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND: Fistula in ano is an abnormal tract or cavity lined by granulation tissue, that connects the Perianal skin to anal canal superficially or anorectum and rectum deeply. It most commonly follows an anorectal sepsis which persists in the intersphincteric plane. This study evaluates the efficacy of LIFT (Ligation of Intersphincteric Tract) in the treatment of fistula in ano with closure of internal opening of fistula tract, drainage of infective foci and eradication of fistulous tract with preservation of sphincter function. AIMS AND OBJECTIVES: This study aims at analysing the effectiveness, peroperative difficulties encountered, postoperative outcomes and complications of LIFT technique as compared to Fistulectomy. METHODS: A Non-randomised control trial (single blind open label control trial) was conducted for 9 months from January 2019 to September 2019 with 140 patients out of which 70 patients underwent LIFT and 70 patients underwent Fistulectomy. All patients were enrolled in the study after a physical examination including digital examination and proctoscopy. The following factors are compared: Duration of surgery, Per-operative complications, Postoperative complications, Length of hospital stay, Readmission and Recurrence. RESULTS: The collected data were analysed and results were computed using unpaired t test and chi square test. This study observed that fistula is more common in males (84.3%) and in 31-40 years age (37.9%) group. The duration of surgery is lesser (mean-34 mins; 30 to 55 minutes) for fistulectomy. Fistulectomy group had Intraoperative complications like bleeding (12.9%) and sphincter injury (17.1%). LIFT has a lesser duration of hospital stay (mean-3.9 days), early wound healing (mean-5; 3-8 weeks) and no recurrence. Anal incontinence was reported in patients of fistulectomy (7.1%) group. CONCLUSION: On basis of the observational results and analysis of this study, it is concluded that, compared to fistulectomy, LIFT procedure is cost-effective, safe and preferred sphincter saving technique for Fistula-in-Ano as this technique has very minimal risk for incontinence and recurrence, and also has short duration of stay in hospital which helps in resuming early to normal daily activities.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711068 |
| Uncontrolled Keywords: | Fistula, LIFT, fistulectomy, sphincter preserving, incontinence. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Feb 2021 02:11 |
| Last Modified: | 09 Feb 2021 02:11 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13955 |
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