Discussion of: “What happens after a failed LIFT for anal fistula?”

• Published in: The American journal of surgery Vol. 214; no. 6; p. 1214
• Main Authors: Wright, Moriah, Thorson, Alan, Blatchford, Garnet, Shashidharan, Maniamparampil, Beaty, Jennifer, Bertelson, Noelle, Aggrawal, Piyush, Taylor, Lindsay, Ternent, Charles A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2017; Elsevier Limited
• Subjects: Anal Canal; Fecal Incontinence; Fistulae; Humans; Patients; Rectal Fistula; Sepsis; Treatment Outcome
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2017.10.020

The 70% success rate that you report is in line with published reports, and as in any study looking at the results from this newer type of procedure from a single institution, the numbers are going to be small, so that really is not surprising. In response to your first question regarding protocol for management of recurrent fistula, we do not have defined pathway for management, but we do have goals of treatment, which is essentially the same goal for any anal fistula, which is to identify, control their sepsis, and hopefully go on to heal that tract.