Meta Analysis Of The Clinical Effect And Safety Of The Ligation Of The Intersphincteric Fistula Tract In The Treatment Of Anal Fistula

Objective: To systematically evaluate the clinical effect and safety in the treatment of ligation of the intersphincteric fistula tract(LIFT)to treat anal fistula.Methods: Made "Ligation of the Intersphincteric Fistula Tract" "LIFT" "Aanl fistula" and other words as the main key words,searched systematically in Pubmed,Medline,Embase,Cochrane library,Wanfang,China national knowledge infrastructure,vip and other domestic and foreign databases,and retrieved clinical studies published from January 1st 2007 to December 31 st 2017.Made the qualified clinical studies included in this systematic evaluation.Finally,took statistical analysis with Revman5.3statistical analysis software.Results: Totally 370 articles were obtained by systematic retrieval.After reading the titles and abstracts of the literature,selected 33 articles,and made 12 articles were included in this analysis according to the inclusion and exclusion criteria by reading the whole article.In which the sample size ranged from 21 to 100,including 1166 patients from January 2011 to March 2017.Follow-up period was 3 to 24 months after the operation.The overall success rate of LIFT surgery was 41.7% to 92.5% and the overall success rate of thread-drawing was 42.55% to 96.1%.1.The successful rate of operation,compared 510 patients in 5 retrospective cohort studies,both clinical success rate of anal fistula treated by LIFT and thread-drawing were higher,the difference was statistically significant(P<0.05),comparison of 7prospective randomized controlled studies including 658 patients showed both clinical success rate of anal fistula treated by LIFT and thread-drawing were higher the difference was not statistically significant(P>0.05);analyzed and compared the prospective and retrospective studies together,both clinical success rate of anal fistula treated by LIFT and thread-drawing were higher the difference was not statistically significant(P>0.05).2.Operation time,compared after dividing 5 randomized controlled studies and 4retrospective cohort studies and combining 9 studies,both operation time of anal fistula treated by LIFT and thread-drawing were lower,the difference was statistically significant(retrospective P<0.00001,randomness P<0.00001,combined P<0.00001).3.Length of hospitalization,compared after dividing 3 randomized controlled studies and 4 retrospective cohort studies and combining 7 studies,both hospitalized length of anal fistula treated by LIFT and thread-drawing were shorter,the difference was statistically significant(retrospective P<0.00001,randomness P<0.00001,combined P<0.00001).4.Healing time of the wound,compared after dividing 4 randomized controlled studies and 4 retrospective cohort studies and combining 8 studies,both healing time of the wound in anal fistula treated by LIFT and thread-drawing were shorter,the difference was statistically significant(retrospective P<0.00001,randomness P<0.00001,combined P<0.00001).5.The incidence of postoperative complications,compared after dividing 4randomized controlled studies,the incidence of postoperative complications in anal fistula treated by LIFT and thread-drawing was lower,the difference was not statistically significant(randomness P>0.05).Compared after combining 4retrospective cohort studies and 8 studies,the incidence of postoperative complications in anal fistula treated by LIFT and thread-drawing was low,the difference was statistically significant(retrospective P<0.05,combined P<0.05).Conclusion: Although there is no significant difference in the success rate between LIFT operation and the thread-drawing operation,and the time of LIFT operation is quite longer than that of thread-drawing operation,but LIFT operation is has quick healing,short hospital stay,less postoperative complications,which is worthy of further clinical application.