Editing Anal fistula surgery (section)

=== '''LIFT (Ligation of the Intersphincteric Fistula Tract)''' ===

* First     described 2007
* Cannulate     and widen external opening
* Particularly     useful in those where advancement flap is difficult - stenosed anus or     very high internal opening
* 1-2cm     curvilinear incision at intersphincteric groove, over the tract, which is     then developed bluntly
* Isolate     fistula tract circumferentially without disrupting it
* Probe     removed
* Both ends of     tract suture-ligated with 3-0 absorbable
* Divide tract     sharply
* Inject     hydrogen peroxide as a leak check
* Reapproximate     anoderm
* Primary     healing rates 47-95%, with worsening of incontinence rare
** Real      success rate in real-world practice seems to be lower than that