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World J Gastrointest Surg. Nov 27, 2026; 18(11): 120547
Published online Nov 27, 2026. doi: 10.4240/wjgs.120547
Effects of modified ligation of intersphincteric fistula tract on intestinal barrier function in patients with transsphincteric anal fistula
Jia-Qi Li, Zhen-Fan Huang, Xi Deng, Zi-Man Xie, Wen-Bin Zhang, Yang Li
Jia-Qi Li, Department of General Practice, The First Hospital Affiliated of Jinan University, Guangzhou 510630, Guangdong Province, China
Zhen-Fan Huang, Department of Gastrointestinal and Anal Surgery, The Second Affiliated Hospital of Guangdong University, Zhanjiang 524000, Guangdong Province, China
Xi Deng, Department of Radiology, The First Hospital Affiliated of Jinan University, Guangzhou 510630, Guangdong Province, China
Zi-Man Xie, The First Clinical Medical College, Jinan University, Guangzhou 510630, Guangdong Province, China
Wen-Bin Zhang, Department of Gastrointestinal Surgery, The First Hospital Affiliated of Jinan University, Guangzhou 510630, Guangdong Province, China
Yang Li, Department of Clinical Nutrition, The First Hospital Affiliated of Jinan University, Guangzhou 510630, Guangdong Province, China
Co-first authors: Jia-Qi Li and Zhen-Fan Huang.
Co-corresponding authors: Wen-Bin Zhang and Yang Li.
Author contributions: Li JQ and Huang ZF contributed to the conception and design, the writing, review, and/or revision of the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Li JQ, Huang ZF, Deng X, Xie ZM, Zhang WB, and Li Y contributed to the analysis and interpretation of data; Zhang WB, and Li Y contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors contributed to the acquisition of data (acquired and managed patients) and final approved the manuscript.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Institutional review board statement: Given the retrospective study design and data anonymization, the Ethics Committee of The First Hospital Affiliated of Jinan University waived the need for ethical review.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Yang Li, MD, Department of Clinical Nutrition, The First Hospital Affiliated of Jinan University, No. 613 Huangpu Avenue West, Tianhe District, Guangzhou 510630, Guangdong Province, China.
155024000@qq.com
Received: May 19, 2026
Revised: July 9, 2026
Accepted: July 29, 2026
Published online: November 27, 2026
Processing time: 176 Days and 18.4 Hours
BACKGROUND
The treatment for transsphincteric anal fistula (TAF) remains challenging. Effective therapies that achieve high efficacy and low recurrence while preserving anal sphincter function are still lacking.
AIM
To analyze the effects of modified ligation of intersphincteric fistula tract (LIFT) on infection-related parameters and intestinal barrier function in patients with TAF.
METHODS
A total of 101 patients with TAF admitted to the First Affiliated Hospital of Jinan University between January 2022 and June 2024 were retrospectively enrolled. Patients were grouped according to the treatment received: The control group (n = 49) underwent conventional anal fistulectomy, whereas the research group (n = 52) underwent modified LIFT. Clinical efficacy, surgical outcomes (e.g., operation time, hospitalization, wound healing time, and postoperative scar area), anal sphincter function assessed using Wexner score, pain intensity assessed using Visual Analogue Scale, infection-related parameters, including white blood cell count, C-reactive protein, and procalcitonin, intestinal barrier function, including diamine oxidase and D-lactic acid, complications, including anal canal deformity, anal edema, infection, constipation, and urinary retention), and the one-year recurrence rate were compared between groups.
RESULTS
Compared with the control group, the research group exhibited a significantly higher total effective rate, shorter operation time, hospitalization, and wound healing time, a smaller postoperative scar area, lower postoperative Wexner and Visual Analogue Scale scores, lower levels of infection-related parameters, and reduced overall complication and one-year recurrence rates. Postoperative intestinal barrier function indicators were comparable between groups.
CONCLUSION
These findings suggest that modified LIFT demonstrates reliable efficacy and safety in patients with TAF.
Core Tip: This retrospective study evaluated and safety of modified ligation of intersphincteric fistula tract in patients with transsphincteric anal fistula. Compared with conventional anal fistulectomy, modified ligation of intersphincteric fistula tract achieved superior efficacy and surgical outcomes. It improved anal sphincter function, alleviated pain, reduced the risk of complications and one-year recurrence rates, and significantly attenuated surgery-related inflammatory responses.
