Department of Surgery, St Mark's Hospital and Academic Institute, London, UK.
Colorectal Dis. 2013 May;15(5):527-35. doi: 10.1111/codi.12224.
Over the last 5 years, the ligation of the intersphincteric fistula tract (LIFT) procedure has become increasingly popular as a sphincter-preserving technique for the treatment of anal fistula. The aim of this article was to review the published literature on the LIFT procedure.
The Cochrane database and EMBASE were searched from January 1980 to November 2012, and PubMed from January 1966 to November 2012. All peer-reviewed studies that investigated the LIFT procedure for the treatment of anal fistula were eligible for inclusion. Technical notes, commentaries, letters and meeting abstracts were excluded. The primary outcome measured was the overall fistula closure rate in relation to the length of follow-up.
Twenty-nine articles were originally identified using the search criteria. Thirteen were finally included for analysis. Sample sizes ranged from 18 to 93 patients, with a pooled total of 498. Most fistulae, 494 (99%), were of cryptoglandular aetiology, of which 470 (94%) were transsphincteric. Overall success rates ranged from 40 to 95%, with a pooled success of 71% (352 of 495 patients; 3 of 498 were lost to follow-up). Follow-up ranged from 1 to 55 months, with a reported mean or median of 4 to 19.5 months. One hundred and eighty-three patients were formally assessed for continence, out of whom 11 (6%) had a minor disturbance.
Overall the systematic review shows that the LIFT procedure appears to be an effective sphincter-conserving approach for the treatment of transsphincteric anal fistula with a pooled healing rate of 71% over a mean or median follow-up period ranging from 4 to 19.5 months.
在过去的 5 年中，结扎肛提肌间瘘管（LIFT）术作为一种保留肛门括约肌的治疗肛瘘的方法越来越受欢迎。本文旨在回顾 LIFT 手术的文献。
检索 Cochrane 数据库、EMBASE 数据库（均从 1980 年 1 月至 2012 年 11 月）和 PubMed 数据库（从 1966 年 1 月至 2012 年 11 月），纳入所有研究 LIFT 手术治疗肛瘘的同行评议文献。技术说明、评论、信件和会议摘要被排除在外。主要结局指标为与随访时间相关的总体瘘管闭合率。
根据检索条件最初确定了 29 篇文章，最终有 13 篇被纳入分析。样本量从 18 例到 93 例不等，共有 498 例。大多数瘘管（494 例，99%）为隐匿性肛腺来源，其中 470 例（94%）为经括约肌瘘。总体成功率为 40%至 95%，总成功率为 71%（495 例中有 352 例；498 例中有 3 例失访）。随访时间为 1 至 55 个月，报告的平均或中位数为 4 至 19.5 个月。有 183 例患者接受了正式的控便能力评估，其中 11 例（6%）有轻微障碍。
总体上，系统评价显示，LIFT 手术似乎是一种有效的保留肛门括约肌的方法，用于治疗经括约肌肛瘘，平均或中位数随访 4 至 19.5 个月的愈合率为 71%。
