Predictive Factors Affecting Recurrence of Anal Fistula after LIFT Procedure.

Objective: To determine the predictive factors affecting the recurrence or persistence of anal fistula of demographic and technical variables.

Study Design: Descriptive study.

Place And Duration Of Study: Department of General Surgery and Radiology, Private Ortadogu Hospital General, Turkey, between 2014 and 2020.

Methodology: The recurrence, persistence, and complication rates of 176 patients who underwent LIFT were compared with demographic and technical data by multivariate logistic regression analysis. Inclusion criteria were patients with anal fistula cryptoglandular origin. Exclusion criteria included patients with intersphincteric fistula, rectovaginal fistula, abscess, pilonidal sinus fistula, and inflammatory bowel disease. Recurrence was defined as the opening of a fistula that persisted after 3 months.

Results: The mean age was 38.6±9.0 years. The mean BMI was 31.9±5.7 Kg/m2. There were no statistically significant differences between the two groups concerning, age, the complexity of fistula tract(s), the surgical technique of suture versus ligation, operation time, and seton placement duration. Twenty-three patients had previous fistula surgery. Twenty-One patients had previously required seton drainage. Higher BMI, being male, having a prior fistula surgery, and having a height IFO >15 were independent risk factors for recurrence (OR =1.28, 5.69, 23.39, and 15.38 respectively).

Conclusion: Higher BMI, male gender, having a prior fistula surgery, and having a height IFO >15 were independent risk factors for recurrence.

Key Words: LIFT, Anal fistula, Recurrence, Wexner incontinence score (WIS), Male, Prior fistula surgery, height 1FO.