A COMPARATIVE STUDY OFLIGATION OF INTERSPHINCTERIC FISTULA TRACT AND FISTULECTOMY IN THE MANAGEMENT OF TRANS SPHINCTERIC FISTULA IN ANO

Background: A fistulectomy involves complete excision of the fistulous tract, thereby eliminating the risk of missing secondary tracts and providing complete tissue for histopathological examination. By studying with comparing the LIFT with fistulectomy withits outcome being advantages and disadvantages in terms of hospital stay, postoperativebleeding, postoperative pain, recurrences, incontinence patient can be benefitted with early outcome with less complications associated, so this study being done to evaluate the standard procedure in terms of with less complication associated. Objectives of the study: To compare the LIFT with fistulectomy in term of operative time, postoperative, bleeding, hospital stay, wound healing, postoperative pain, recurrence, incontinence Methods: Patients satisfying inclusion criteria are enrolled within 24 hours of admission after informed consent. All the patients with Trans sphincteric fistula in ano will be evaluated with thorough clinical examination, radiological and laboratory investigations. Those who require surgery will be admitted and appropriate surgery will be performed .and analyzed for in term of operative time, postoperative bleeding, hospital stay, postoperative pain, recurrence, incontinence. Results: Majority of patients belonged to the age group of 30 -40 years. M:F is 4:1, Duration of hospital stay is significantly low in LIFT group with P<0.417, Post-operative pain is less in LIFT group with P<0.002, Post-operative woundHealing time are less with LIFT group . Incontinence is less with LIFT group when compared to Fistulectomy with P<0.0452, recurrence is noted in either group but more in LIFT group. Success rate in our study is 90% in LIFT group. Interpretation and conclusion: LIFT is associated with less postoperative pain, shorter duration of hospital stay and a quicker recovery, shorter duration of surgery, earlier return to work as compared with fistulectomy. LIFT procedure is not associated with major post-operative complications. There is no incontinence in the follow up period of six months.