Comparative Study between Ligation of Intersphincteric Fistula Tract (LIFT) Versus Seton in Treatment of Perianal Fistula

Introduction: Fistula in-ano or perianal fistula is a chronic abnormal communication which extends from anorectal lumen (internal opening) to external opening over the skin of perineum. Per-rectal examination is mandatory to assess the internal opening and also to assess the other associated conditions like anal fissure, hemorrhoids. The main principles of anal fistula surgery are to eliminate the fistula tract, prevent recurrence and preserve anal sphincter function. These surgical procedure Ligation of Intersphincteric fistula tract and Seton placement are being widely used to treat the perianal fistula or fistula in-ano. This research paper aims to compare the advantages and disadvantages between ligation of intersphincteric fistula tract versus Seton placement in treatment of perianal fistula. The study to evaluate parameters such as post-operative pain using VAS score, study to compare the patient's quality of life and other complications like fecal incontinence, recurrence and duration of hospital stay to determine most effective treatment method. Methodology: The study involves a comparative analysis of the patients undergoing Ligation of intersphinteric fistula tract and Seton procedure for treatment of Peri-anal fistula or fistula in ano with parameters such as post -operative pain using VAS score, post-operative quality of life and recurrence, fecal incontinence, Emotional health and Daily Physical activity of Patients. Result: The result indicate that both the procedure is safe in terms of fecal incontinence and recurrence and post-operative pain on Post-operative day 1 is more associated with LIFT procedure as compare to Seton. Post-operative discomfort is more with Seton placement and social activity limitation is slightly higher with Seton. Discussion: Currently fistulectomy, laser treatment, Ligation of inter-sphincteric fistula tract and Seton placement procedure is being performed frequently for the treatment of fistula in perianal fistula. current paper reports on comparision of these procedures LIFT and Seton are better in terms of fecal incontinence and recurrence for the treatment of fistula in ano. social activity limitation is slightly higher with Seton procedure as compare to LIFT procedure. Post-Operative pain on day one is more with LIFT as compare to Seton but pain on post-operative day-15 is slightly more with Seton as compare to LIFT procedure. Conclusion: In both the procedure recurrence rate is very low, there is no fecal incontinence with both procedures. There significant difference in postoperative pain on day one which is more with LIFT as compare to Seton placement. Social and emotional behavior is slightly more affected with Seton placement as compare to Ligation of inter-sphincteric fistula tract surgery.