الفهرس 
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Abstract
Summary
Anal fistula is the chronic phase of anorectal infection is characterized by chronic purulent drainage or cyclic pain associated with acute relapse of the abscess followed by intermittent spontaneous decompression.
Anal fistula is a chronic infected tract developing between the anal canal and the perianal skin. Most commonly due to a cryptoglandular infection, it appears after drainage of a perianal abscess, although other causes include Crohn’s disease, trauma, radiation, or malignancy. Anal fistulas include high transsphincteric, suprasphincteric, or extrasphincteric fistulas.
The best treatment for anal fistula should eliminate infection and promote healing of the tract, whilst preserving the anal sphincter complex and full continence.
No single technique has been shown to be suitable for all cases. The treatment of anal fistula is mainly surgical to eliminate the fistula, prevent recurrence and preserve anal continence
Furthermore, recurrence rates after surgery seem to be high although studies with proper follow-up are scarce. Therefore, anal fistulas management remains a challenge for surgeons worldwide. Therefore, there is no rigid model of choice of surgical treatment to be used.
The ligation of the intersphincteric fistula tract (LIFT) procedure has been described as the most recent innovation to sphincter-preserving surgery for the management of complex anal fistulas.
This is a prospective case series study that was carried out on 20 patients who presented with transsphincteric anal fistula and were treated with the LIFT technique in the Department of General Surgery, Beni- Suef University Hospital.
After hospital discharge, patients were invited to attend to follow-up visit on weeks 1, 2, and 6, also at months 3 and 6 postoperatively. We assessed postoperative pain, bleeding, incontinence, and urinary retention.
Patients ranging from 35 to 59 years and the mean age was 47.3 ± 6.44 years. 16 patients were males and only four females.
The operative time in the study ranged from 25 to 55 min and there were no complications during operations.
All patients experienced neither bleeding nor incontinence postoperatively. Only three patients had postoperative urine retention and four patients presented with local wound infection.
Eighteen patients achieved complete fistula healing, whereas only two patients developed recurrence through the wound and they were managed 3 months later by fistulotomy, with complete resolution.
LIFT is a safe and effective procedure in the treatment of simple anal fistulas. LIFT led to less postoperative pain, shorter healing time, and a low incidence of recurrence, and was also a sphincter-preserving procedure.