Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
Outcome of transanal advancement flap repair (TAFR) as salvage therapy after failed ligation of intersphincteric fistula tract (LIFT)-A proposed algorithm after failed LIFT.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ergüder E, Verkade C, Ersak C, van Oostendorp J Y, Han-Geurts I J M, Wasowicz D K, Zimmerman D D E
Аннотация
AIM: To assess the outcomes of transanal advancement flap repair (TAFR) following failed ligation of intersphincteric fistula tract (LIFT) treatment for cryptoglandular anal fistulas, with a focus on healing and functional results.
METHODS: This retrospective observational cohort study included patients who underwent TAFR after a failed LIFT procedure for cryptoglandular perianal fistulas at two Dutch referral centers between 2015 and 2023. Pre- and postoperative continence data were gathered prospectively, while long-term outcomes, including success rates and faecal continence, were evaluated using the Faecal Incontinence Severity Index (FISI) through questionnaires distributed in 2023.
RESULTS: Of the 129 patients who underwent LIFT, 90 (70%) experienced failure of the procedure. A total of 24 patients, including those referred from other centres after failed LIFT, underwent TAFR, with a success rate of 71% (17 out of 24). No significant differences in faecal continence were observed between preoperative and postoperative FISI scores. Body mass index (BMI) was significantly associated with healing outcomes (p < 0.05), indicating that patients with a lower BMI had higher healing rates.
CONCLUSION: TAFR following failed LIFT surgery shows healing results equivalent to those of initial fistula repairs, with obesity emerging as a potential predictor of healing success. These findings support current guideline recommendations favouring TAFR as the preferred salvage procedure after failed LIFT.
METHODS: This retrospective observational cohort study included patients who underwent TAFR after a failed LIFT procedure for cryptoglandular perianal fistulas at two Dutch referral centers between 2015 and 2023. Pre- and postoperative continence data were gathered prospectively, while long-term outcomes, including success rates and faecal continence, were evaluated using the Faecal Incontinence Severity Index (FISI) through questionnaires distributed in 2023.
RESULTS: Of the 129 patients who underwent LIFT, 90 (70%) experienced failure of the procedure. A total of 24 patients, including those referred from other centres after failed LIFT, underwent TAFR, with a success rate of 71% (17 out of 24). No significant differences in faecal continence were observed between preoperative and postoperative FISI scores. Body mass index (BMI) was significantly associated with healing outcomes (p < 0.05), indicating that patients with a lower BMI had higher healing rates.
CONCLUSION: TAFR following failed LIFT surgery shows healing results equivalent to those of initial fistula repairs, with obesity emerging as a potential predictor of healing success. These findings support current guideline recommendations favouring TAFR as the preferred salvage procedure after failed LIFT.