LIGATION OF THE INTERSPHINCTERIC FISTULA TRACT IN TREATMENT OF CHRONIC PARAPROCTITIS
In the review, a comparative analysis of the use of traditional techniques and organ-preserving ligation of intersphincteric fistula tract (LIFT) in the treatment of chronic paraproctitis was carried out. The use of traditional methods is effective in 60-80% of cases; nevertheless the risk of anal incontinence formation is, on average, 28%. The ligation of the intersphincteric fistula tract (LIFT) allows achieving convalescence in 82 - 95% of cases, and besides the majority of specialists emphasizes almost complete absence of disturbance of anal competence. In the vast majority of cases, recurrence of the postoperative fistula is formed as intersphincteric type that allows eliminating it without any risk of incontinence. In rare cases of «complete» recurrent fistula formation there is a possibility to perform sphincter-preserving operation. In patients with initially recurrent fistulas, the percentage of recovery is 90% and more. While comparing the classical operation LIFT and LIFT-plus (with the removal of distal part of fistula), the efficiency of LIFT- plus is higher by an average of 4-5%. The performed analysis proves the advantages of the sphincter-saving operation LIFT in comparison with the classical methods of elimination of the pararectal fistulas. The problem of combining the LIFT with other procedures remains unsolved and demands further investigations.