Comparative Study between Open Fistulectomy and Ligation of Inter-Sphincteric Fistula Tract (LIFT) Procedure for Uncomplicated Perianal Fistula
Submission: 01 October 2025 | Acceptance: 20 November 2025 | Publication: 07 December 2025
1Tanveer Hussain Mughal, 2Adnan Mehraj, 3Raja Naveed Amjid Khan, 4Nadar Hussain, 5Hina Tariq, 6Dr Arwah asif
1Post graduate resident FCPS II Surgery
2Professor of surgery CMH Muzaffarbad AJK
3Post graduate resident FCPS II surgery
4Post graduate resident FCPS II surgery
5CMH Hospital Muzaffarbad
6CMH Hospital Muzaffarbad
Abstract
Background:
The treatment of perianal fistulas, especially trans-sphincteric varieties, is extremely difficult and frequently requires surgery.
Methodology:
The study design was a randomised controlled trial. The study was conducted at Combined Military Hospital/Sheikh Khalifa Bin Zyed Al-Nahyan Hospital, Muzaffarabad, AJ&K, and Pakistan. This study lasted for nine months following CPSP’s approval of the synopsis. The study included 160 patients, divided equally into two groups of 80 each. The data was analysed by the IBM SPSS version 27. Continuous variables (age, VAS scores, healing time) were presented as mean±standard deviation (SD) and compared using an independent t-test. For categorical variables chi-squared test was applied.
Results:
The LIFT technique led to significantly lower pain ratings compared to open fistulectomy at 24 hours (4.9 vs. 6.8, p-value <0.001), 1 week (3.6 vs. 5.2, p-value <0.001), 1 month (2.4 vs. 3.1, p < 0.001), and 3 months (0.9 vs. 1.2, p < 0.004). Subsequently, 6 months after, pain levels were almost similar (LIFT: 0.4 vs. Open Fistulectomy: 0.5, p=0.008). Patients undergoing procedure Open Fistulectomy had a longer mean healing time (29.5 days) compared to the LIFT technique (22.1 days, p-value <0.001). Furthermore, the LIFT technique group showed fewer recurrences (5.0%) compared to Open Fistulectomy (13.75%, p-value=0.048).
Conclusion:
The LIFT technique surpassed open fistulectomy in terms of early-to-mid-term pain relief, wound healing time and fistula recurrence rate. Keywords: Fistula, Crohn’s disease, Wound, Healing