***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE : This study was design ed to assess the total anal sphincter – saving technique of ligating the intersphincteric fistula tract for the treatment of fistula-in-ano . METHODS : We performed a prospect i ve observational study of patients with fistula-in-ano treated with the ligation of the intersphincteric fistula tract technique from May 2007 through September 2008 . All patients had fistulas arising from cryptogl and ular infections .  Recurrence rate , healing time , and morbidities related to the procedure were determined with a st and ard follow-up protocol . RESULTS : Forty-five patients with transsphincteric ( n = 33 ) or complex ( n = 12 ) fistulas were included in the study . Five patients ( 11.1 % ) had recurrent fistula-in-ano after prior surgery using other recognized treatment procedures . The median age was 41.5 ( range , 27–56 ) years ; median follow-up , 9 ( range , 2–16 ) months . Primary healing was achieved in 37 patients ( 82.2 % ) , with a median healing time of 7 ( range , 4–10 ) weeks . Eight patients ( 17.7 % ) had recurrence of fistula between 3 and 8 months after the operation . No clinical ly significant morbidity was noted in any of the 45 patients . CONCLUSIONS : The ligation of the intersphincteric fistula tract technique for fistula-in-ano surgery , which aims at total anal sphincter preservation , appears to be both safe and easy to perform , with encouraging early outcomes Purpose Long-term closure rates of anorectal fistulas using fibrin glue have been disappointing , possibly because of the liquid consistency of the glue . A suturable bioprosthetic plug ( Surgisis ® , Cook Surgical , Inc. ) was fashioned to close the primary opening of fistula tracts . A prospect i ve cohort study was performed to compare fibrin glue vs. the anal fistula plug . Methods Patients with high transsphincteric fistulas , or deeper , were prospect ively enrolled . Patients with Crohn 's disease or superficial fistulas were excluded . Age , gender , number and type of fistula tracts , and previous fistula surgeries were compared between groups . Under general anesthesia and in prone jackknife position , the tract was irrigated with hydrogen peroxide . Fistula tracts were occluded by fibrin glue vs. closure of the primary opening using a Surgisis ® anal fistula plug . Results Twenty-five patients were prospect ively enrolled . Ten patients underwent fibrin glue closure , and 15 used a fistula plug . Patient 's age , gender , fistula tract characteristics , and number of previous closure attempts was similar in both groups . In the fibrin glue group , six patients ( 60 percent ) had persistence of one or more fistulas at three months , compared with two patients ( 13 percent ) in the plug group ( P < 0.05 , Fisher exact test ) . Conclusions Closure of the primary opening of a fistula tract using a suturable biologic anal fistula plug is an effective method of treating anorectal fistulas . The method seems to be more reliable than fibrin glue closure . The greater efficacy of the fistula plug may be the result of the ability to suture the plug in the primary opening , therefore , closing the primary opening more effectively . Further prospect i ve , long-term studies are warranted Background Ligation of the intersphincteric tract ( LIFT ) , a novel sphincter-saving technique , has been recently described with promising results . Literature data are still scant . In this prospect i ve observational study , we present our experience with this technique . Methods Between October 2010 and April 2011 , 18 patients with ‘ complex ’ fistulas underwent LIFT . All patients were enrolled in the study after a physical examination including digital examination and proctoscopy .  For the purpose of this pilot study , fistulas were classified as complex if any of the following conditions were present : tract crossing more than 30 % of the external sphincter , anterior fistula in a woman , recurrent fistula or pre-existing incontinence . Endpoints were healing time , presence of recurrence , faecal incontinence and surgical complications . Results Ten patients were men and 8 were women ; mean age was 39 years ; minimum follow-up was 4 months . Three patients required drainage seton insertion and delayed LIFT . After LIFT , 1 patient experienced haemorrhoidal thrombosis . At the end of the follow-up , 15 patients ( 83 % ) healed with no recurrence . Three patients had persistent symptoms and required further surgical treatment . We did not observe postoperative worsening of continence . Conclusions Results from our pilot study indicate that this novel sphincter-saving approach is effective and safe for treating complex anal fistula Ligation of the intersphincteric fistula tract ( LIFT ) is a novel sphincter‐preserving technique for anal fistula . This pilot study was design ed to evaluate the results in patients with a recurrent fistula Seventy‐four patients who underwent seton treatment of high anal fistulae over a 6‐year period have been review ed . Four different techniques were used : staged fistulotomy ( n = 24 ) , cutting seton ( n = 13 ) , short‐term seton drainage ( n = 14 ) and long‐term seton drainage in patients with Crohn 's disease ( n = 23 ) . Recurrence developed in two patients ( 8 per cent ) undergoing two‐stage fistulotomy ; two patients ( 14 per cent ) undergoing short‐term drainage and nine ( 39 per cent ) of the patients with Crohn 's disease . Three patients with Crohn 's disease required proctectomy for progressive perianal disease . The remaining 11 patients with Crohn 's disease ( 48 per cent ) obtained a good result . None of the patients treated with a cutting seton  developed a recurrence . Minor incontinence developed in 13 patients ( 54 per cent ) undergoing two‐stage fistulotomy and seven patients ( 54 per cent ) treated with a cutting seton . When sphincter muscle was not divided , five patients ( 36 per cent ) undergoing short‐term drainage and six patients ( 26 per cent ) undergoing long‐term drainage developed minor incontinence .  High  complex fistulae can be successfully treated with only minor loss of continence using different seton techniques . In high Crohn 's fistulae , long‐term seton drainage preserves sphincter function , but recurrence is common if the seton is removed BACKGROUND The ligation of intersphincteric fistula tract ( LIFT ) is a relatively new surgical technique for treating complex anorectal fistulas . METHODS LIFT was compared with anorectal advancement flap management ( ARAF ) of complex anorectal fistulas requiring previous seton drainage . Crohn 's patients were excluded . Patients with no confirmed recurrent sepsis after 6 months were r and omized to day surgery performance of  LIFT ( 25 ; 17 male ) or ARAF ( 14 ; 10 male ) with removal of the seton . Outcome measures included recurrences , surgical time , complications , hospital readmissions , and fecal incontinence . RESULTS LIFT was 32.5 minutes shorter than ARAF ( P < .001 ) . Complications were similar , with no hospital readmissions . Return to normal activities was 1 week for LIFT patients , 2 weeks for ARAF patients ( P = .016 ) . At 19 months there were 3 recurrences ( 2 in the LIFT group ) . One ARAF patient had minor incontinence . CONCLUSIONS The LIFT procedure was simple , safe , shorter , and patients returned to work earlier . All patients had preliminary seton drainage , possibly contributing to the low recurrence rates OBJECTIVE To describe a new technique for fistula-in-ano surgery aim ed at total sphincter preservation , and evaluate the preliminary results concerning non-healing and intact anal function . MATERIAL AND METHOD A prospect i ve observational study in eighteen fistula-in-ano patients treated by ligation of intersphincteric fistula tract ( LIFT ) technique , from January to June 2006 . RESULTS Fistula-in-ano in seventeen patients healed primarily ( 94.4 % ) . There was one non-healing case ( 5.6 % ) . The mean healing time was four weeks . None had disturbances in clinical anal continence . CONCLUSION The early outcome of the LIFT technique is quite impressive . Results warrant a larger study with long-term evaluation . This technique has the potential to become a viable option for fistula-in-ano surgery INTRODUCTION : The management of complex fistulas is difficult . Maintaining continence while achieving durable fistula closure is the goal of surgical management . This study describes our experience with a novel sphincter-sparing technique called the ligation of the intersphincteric fistula tract , which involves ligation and division of the fistula tract in the intersphincteric space . METHODS : All patients from July 2007 to December 2008 with trans- or suprasphincteric fistula treated with the procedure were prospect ively followed . Procedures were performed by surgeons with fellowship training in a referral center . Demographic data , comorbidities , previous repair attempts , and postoperative data were collected . RESULTS : A total of 39 patients underwent a ligation of the intersphincteric fistula tract  during a 17-month period . Median age was 49 years . A total of 29 patients ( 74 % ) had previous attempts at repair , with a median of 2 failed repairs . Follow-up data were available in 90 % ( 35 of 39 ) . Median follow-up was 20 weeks . Successful fistula closure was achieved in 57 % of the patients ( 20 of 35 ) . Median time to failure was 10 weeks ( range , 2–38 weeks ) . No patient reported any subjective decrease in continence after the procedure . CONCLUSION : Ligation of the intersphincteric fistula tract is a new sphincter-sparing procedure for complex transsphincteric fistula . The success rate is comparable with other sphincter-preserving techniques . Importantly , it appeared to effectively preserve continence . Adding safe , muscle-sparing surgical options to our armamentarium for dealing with transsphincteric fistula is essential . Additionally , the procedure is easy to learn and has very low cost . Long-term follow-up and r and omized , controlled trials are necessary to assess efficacy and durability 
    Output:
    
There was no association between pre-LIFT drainage seton and success of LIFT .
Ligation of the intersphincteric fistula tract appears to be an effective and safe treatment for trans-sphincteric or complex anal fistula .
Combining other procedures and a pre-LIFT drainage seton does not seem to confer any added benefit in terms of success .