Outcomes of Ligation of Intersphincteric Fistula Tract (LIFT) Technique Versus Fistulotomy in the Surgical Treatment of Trans-sphincteric Perianal Fistula

Abstract

Background: Trans-sphincteric peri-anal fistulae represent a complex surgical challenge due to their tendency for recurrence and the risk of fecal incontinence. Fistulotomy has long been considered the standard procedure for low trans-sphincteric tracts, offering high healing rates but at the cost of sphincter division. In contrast, the ligation of the intersphincteric fistula tract (LIFT) technique has emerged as a sphincter-preserving alternative, aiming to achieve durable healing while minimizing continence impairment. This review summarizes the comparative outcomes of LIFT and fistulotomy in terms of healing rates, recurrence, postoperative pain, wound healing time, complications, and continence preservation, highlighting their respective indications and limitations.