Comparing Two Surgical Treatments for High Anal Fistula Intra-anal Fistulotomy With Fistula Opening Closure IFOC Versus Ligation of the Intersphincteric Fistula Tract LIFT

What this Trial Is About

Researchers are evaluating two surgical procedures, Intra-anal Fistulotomy With Fistula Opening Closure IFOC and Ligation of the Intersphincteric Fistula Tract LIFT, in patients with high anal fistula, a condition involving more than one-third of the sphincter complex. This pilot randomized controlled trial aims to compare early outcomes such as failure rates, healing, continence, and complications in patients treated for this condition. Participants will be randomly assigned to one of two groups one group will undergo the LIFT procedure, where the fistulous tract is dissected, ligated, and divided, while the other group will receive the IFOC procedure, involving intra-anal fistulotomy, curettage, closure of the internal opening, and drainage. Both procedures follow standard surgical techniques. Postoperative care includes early oral intake and planned discharge on the first day after surgery, with follow-up visits scheduled for at least six months to monitor recovery and detect any complications or recurrence. During the study, participants will have comprehensive assessments including medical history, clinical examination identifying fistula openings, discharge evaluation, and continence scoring using the Jorge-Wexner incontinence score. MRI fistulogram will be used preoperatively to map the fistula tract. Follow-up visits at 1 week, 2 weeks, 1 month, and monthly thereafter will assess healing, surgical site infection, pain, bleeding, incontinence, urine retention, and time to return to normal activities. The main outcome measured is the failure rate of the two procedures up to six months after surgery.

IFOC Compared With LIFT in High Anal Fistula