Effect of intersphincteric fistula tract ligation versus anal fistulectomy on pain scores and serum levels of vascular endothelial growth factor and interleukin-2 in patients with simple anal fistulas

Abstract

Objective: This study was performed to explore the effects of ligation of the intersphincteric fistula tract (LIFT) on pain scores and serum levels of vascular endothelial growth factor (VEGF) and interleukin (IL)-2 in patients with simple anal fistulas.

Methods: Ninety patients with simple anal fistulas were evenly randomized into a study group (treated with LIFT) and a control group (treated with traditional anal fistulectomy) according to a random number table. The surgical outcomes, basic operation conditions (operation time, hospital stay, and anal continence), and postoperative wound healing rates were compared between the two groups.

Results: The study group had significantly better operation conditions (better anal continence and shorter length of hospital stay), a higher postoperative wound healing rate, lower pain scores, higher VEGF and IL-2 levels, and higher overall efficacy rate than the control group. However, the incidence of postoperative complications was not significantly different between the two groups.

Conclusions: Patients who underwent LIFT had better surgical outcomes, higher wound healing rates, better anal continence, a shorter length of hospital stay, and less severe postoperative pain than those who underwent simple anal fistulectomy. Increased levels of VEGF and IL-2 after surgery may promote wound healing.

Keywords: Simple anal fistula; anal fistulectomy; interleukin-2; ligation of the intersphincteric fistula tract; vascular endothelial growth factor; wound healing.

Figure 1.

Comparison of postoperative pain scores between the two groups at different time points. The postoperative pain scores at different time points were significantly different between the two groups (P < 0.05). The study group had lower postoperative pain scores than the control group on days 1, 3, and 5 (P < 0.05), although the scores gradually decreased in both groups (P < 0.05). *P < 0.05 in the study and control groups.

Figure 2.

Comparison of (a) VEGF and (b) IL-2 levels between the two groups. No significant difference was observed in the VEGF or IL-2 levels between the study and control groups preoperatively. Postoperatively, however, the study group had significantly higher VEGF and IL-2 levels than the control group (P < 0.05), and a significant increase in the levels was found in both groups (P < 0.05). *P < 0.05 postoperatively compared with that preoperatively; ^#P < 0.05 postoperatively compared with that preoperatively in the control group. VEGF, vascular endothelial growth factor; IL-2, interleukin-2.