TITLE:
Ligation of the Intersphincteric Fistula Traject with Placement of a Prosthesis: A New Technique in the Treatment of Fistula-in-Ano at Yaounde Central Hospital (Cameroon)
AUTHORS:
Eric Patrick Savom, Georges Roger Bwelle Motto, Guy Aristide Bang, Joseph Cyrille Chopkeng, Ricardo Fomene Ngouanet, Ghislain Loïc Batimba Nolabia, Arthur Essomba
KEYWORDS:
High Anal Fistula, LIFT-Plug, Healing, Postoperative Complications, Recurrence
JOURNAL NAME:
Surgical Science,
Vol.13 No.2,
February
24,
2022
ABSTRACT: Background: Ligation of the inter-sphincter fistula tract associated with anal plug
(LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central
Hospital. A two-sided prosthesis piece bent in the shape of a cone is used here
as an anal plug. The aim of this work was to evaluate the therapeutic results
and the safety of this device. Patients
and Methods: The clinical data of patients operated by the LIFT-Plug technique from
January 1, 2020 to June 30, 2021 for a high
anal fistula were analyzed prospectively. The variables evaluated were
operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was
1.15. No patient presented preoperative continence disorder. The fistula was
high trans-sphincteric in 89.3% of cases. The average duration of surgery was
55.2 minutes (45 to 66 minutes). The postoperative course was straightforward,
although 60.7% of the patients had experienced tingling that resolved
spontaneously. Three patients (10.7%) presented with transient gas incontinence
(WIS of 4) which completely resolved after one month. All patients healed
within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective
technique for the treatment of upper anal fistula without major impairment
of continence despite delayed healing. The adapted two-sided prosthesis is a
good alternative to the conventional anal plug.