ArticleCureus2025
Mucosal Advancement Flap Versus Ligation of the Intersphincteric Fistula Tract for Transsphincteric Fistula-in-Ano: A Comparative Study in a Tertiary Care Hospital.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
Background and aim Transsphincteric fistula-in-ano (TPAF) is a common anorectal condition that poses significant surgical challenges due to the involvement of the external anal sphincter and the risk of postoperative incontinence. Sphincter-preserving procedures such as the mucosal advancement flap (MAF) and ligation of the intersphincteric fistula tract (LIFT) have become preferred alternatives; however, their comparative outcomes remain debated. This study aimed to compare postoperative outcomes between the MAF and LIFT procedures in patients with TPAF. Methods A prospective comparative study was conducted in the Department of General Surgery, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, from June 2025 to September 2025. A total of 14 patients diagnosed with TPAF were randomized into two groups: Group A (MAF, n = 7) and Group B (LIFT, n = 7). Postoperative pain (Visual Analogue Scale (VAS) score), wound infection, time to complete healing, anal continence (Wexner score), and recurrence were assessed during a one-month follow-up. Results The mean age of the study population was 46.8 years, with a male-to-female ratio of 3:2. Postoperative pain at 48 hours was significantly lower in the LIFT group (VAS 3.1 ± 0.6) compared to the MAF group (VAS 4.8 ± 0.9, p = 0.02). Complete wound healing occurred faster with MAF (mean 18.6 ± 3.2 days) than with LIFT (21.4 ± 3.9 days, p = 0.05). Minor wound infection occurred in one patient (14.3%) from each group. No major incontinence was reported in either group, and no recurrence was observed at one month. Conclusions Both MAF and LIFT are safe and effective sphincter-preserving techniques for managing TPAF. LIFT offers reduced postoperative pain and shorter operative time, while MAF offers faster healing. Larger, multicenter trials with extended follow-up are warranted to establish long-term efficacy.
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