Amr, W., Mohammad, H., Abdultawwab, M., Yassin, M. (2022). Laser versus Ligation as Sphincter Preserving Techniques in the Management of Intersphincteric Perianal Fistula. The Egyptian Journal of Hospital Medicine, 88(1), 3412-3416. doi: 10.21608/ejhm.2022.248718
Wesam Mohammad Amr; Hatem Mohammad; Mahmoud Sobhi Abdultawwab; Mahmoud Abdou Yassin. "Laser versus Ligation as Sphincter Preserving Techniques in the Management of Intersphincteric Perianal Fistula". The Egyptian Journal of Hospital Medicine, 88, 1, 2022, 3412-3416. doi: 10.21608/ejhm.2022.248718
Amr, W., Mohammad, H., Abdultawwab, M., Yassin, M. (2022). 'Laser versus Ligation as Sphincter Preserving Techniques in the Management of Intersphincteric Perianal Fistula', The Egyptian Journal of Hospital Medicine, 88(1), pp. 3412-3416. doi: 10.21608/ejhm.2022.248718
Amr, W., Mohammad, H., Abdultawwab, M., Yassin, M. Laser versus Ligation as Sphincter Preserving Techniques in the Management of Intersphincteric Perianal Fistula. The Egyptian Journal of Hospital Medicine, 2022; 88(1): 3412-3416. doi: 10.21608/ejhm.2022.248718
Laser versus Ligation as Sphincter Preserving Techniques in the Management of Intersphincteric Perianal Fistula
11General Surgery Department, Zagazig University Hospital, Egypt
21General Surgery Department, Zagazig University Hospital, Egypt.
32Department of General Surgery, Al Ahrar Zagazig Teaching Hospital, Egypt
Abstract
Background: Fistula tract Laser closure (FiLaC) and Ligation of intersphincteric Fistula Tract (LIFT) are feasible and safe techniques with low postoperative pain and minimal incontinence. Objectives: Our study aimed to preserve the anal sphincter and decrease the rate of incontinence and recurrence of the fistula during the management of intersphincteric perianal fistula. Patients and Method: This was a prospective observational study for 6 months at Department of General Surgery, Zagazig University Hospitals. Two groups of 56 patients were formed. Group A underwent fistula tract laser closure and group B ligation of intersphincteric fistula tract. Patients were followed for 6 months for postoperative pain, recurrence, and complication. Results: In our analysis, the average operating time was 19.3 minutes (min), while in the LIFT group it was 48.6 min with a statistically significantly higher mean operation time in the LIFT group. The mean hospital stay time postoperatively in the FiLac group was 8.1 hours, which was significantly lower than in the LIFT group (17.1 hours). In the FiLaC group, the mean time of healing was 16.4 days while in LIFT the mean healing time was 32 days, which was statistically higher than the FilaC group. Postoperative pain was statistically wrose in the LIFT group than the FiLaC group. There was no substantial difference between the two groups after a considerable period of follow-up. Conclusion: Our research found that both approaches are promising techniques, with higher healing rates and a lower risk of incontinence or recurrence after surgery. However, LIFT was quite significantly better for healing rate and recurrence, while fistula tract laser closure was slightly significantly better for postoperative pain and incontinence.