Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

This article describes the surgical treatment of fecal incontinence. There are many surgical methods for fecal incontinence, and each treatment has its own advantages and disadvantages and indications. The appropriate surgical procedure should be selected according to the patient's history, anatomical structure and severity of incontinence. Injectable bulking agents is suitable for passive fecal incontinence. Sphincteroplasty is suitable for patients with sphincter injury caused by vaginal delivery or surgical trauma. Sacral nerve stimulation and posterior tibial nerve stimulation are relatively conservative methods. Gracilomyoplasty, artificial anal sphincter or magnetic anal sphincter can be used in the treatment of refractory fecal incontinence, but with many complications. Colostomy is the ideal choice for patients who have failed to respond to conservative treatment and cannot undergo these procedures.

This article describes the surgical treatment of fecal incontinence. There are many surgical methods for fecal incontinence, and each treatment has its own advantages and disadvantages and indications. The appropriate surgical procedure should be selected according to the patient's history, anatomical structure and severity of incontinence. Injectable bulking agents is suitable for passive fecal incontinence. Sphincteroplasty is suitable for patients with sphincter injury caused by vaginal delivery or surgical trauma. Sacral nerve stimulation and posterior tibial nerve stimulation are relatively conservative methods. Gracilomyoplasty, artificial anal sphincter or magnetic anal sphincter can be used in the treatment of refractory fecal incontinence, but with many complications. Colostomy is the ideal choice for patients who have failed to respond to conservative treatment and cannot undergo these procedures.

Objective:To correlate peripheral blood hypersensitive C-reactive protein (hs-CRP) with cognitive function in patients with depression.Methods:Seventy-five patients with depression who received treatment in the Second People's Hospital of Lishui from January 2019 to May 2020 were included in the depression group. An additional 50 healthy controls were included in the control group. The MATRICS Consensus Cognitive Battery (MCCB) was used to evaluate participates' cognitive function. Serum hs-CRP level was determined using enzyme-linked immunosorbent assay.Results:Speed of processing, working memory, verbal learning, visual learning and reasoning/problem-solving scores in the depression group were significantly lower than those in the control group ( t = 10.774, 2.774, 9.840, 5.064, 7.915, all P < 0.01). Serum hs-CRP level in the depression group was significantly higher than that in the control group [(13.05 ± 2.94) mL vs. (1.13 ± 0.18) mL, t = 28.595, P < 0.01]. Speed of processing, working memory, verbal learning, visual learning and reasoning/problem-solving scores in patients with moderate and severe depression were significantly lower than those in patients with mild depression. Serum hs-CRP level in patients with moderate and severe depression was (10.41 ± 2.21) mg/L and (25.71 ± 4.04) mg/L, respectively, which was significantly higher than that in patients with mild depression [(3.03 ± 0.49) mg/L, t = 3.015, 3.370; 3.903, 3.441; 3.541, 3.604; 4.503, 4.661; 4.001, 3.980; 4.035, 3.669, all P < 0.01]. Speed of processing, working memory, verbal learning, visual learning and reasoning/problem-solving scores in patients with severe depression were significantly lower than those in patients with moderate depression ( t = 8.331, 5.227, 10.031, 6.003, 9.416, all P < 0.01). Serum hs-CRP level in patients with severe depression was significantly higher than that in patients with moderate depression [(25.71 ± 4.04) mg/L vs. (10.41 ± 2.21) mg/L, t = 11.005, P < 0.01]. Pearson correlation analysis showed that serum hs-CRP level in patients with depression was remarkably negatively correlated with speed of processing, working memory, verbal learning, visual learning and reasoning/problem-solving scores (all P < 0.01). Conclusion:Serum hs-CRP level in patients with depression is greatly increased, can reflect the severity of depression and is related to cognitive function.

This paper delineate the definition,etiology and treatment of fecal incontinence,Initial management of fecal incontinence consists of supportive care and medical therapy.If patients fail to re-spond to initial management,such patients should undergo additional evaluation(such as anorectal manom-etry,endorectal ultrasound and magnetic resonance imaging)to detect functional and structural abnormali-ties causing fecal incontinence and to guide subsequent management.For patients who fail to respond to initial management,options include biofeedback,injectable anal bulking agent,sacral nerve stimulation, and anal sphincteroplasty.Dynamic graciloplasty and artificial anal sphincter devices are associated with significant morbidity and should therefore only be used to treat refractory fecal incontinence.Fecal diver-sion with a colostomy should be reserved for patients with intractable symptoms who are not candidates for any other therapy,or in whom other treatments have failed.

Objective To summarize the magnetic resonance imaging (MRI) features of the persistcnt perineal sinus (PPS).Methods The retrospective and descriptive study was conducted.The clinical data of 7 patients with PPS who were admitted to the Nanjing University of Traditional Chinese Medicine between July 2010 and January 2017 were collected.Patients received horizontal,anteroposterior axes and coronal scanning of MRI after abdominoperineal resection (APR) of rectal cancer.Two physicians read collectively films and then achieved consistent results if there was a disputed result.Observation indicators:(1) MRI features;(2) treatment and follow-up situations.Patients underwent resection of PPS according to results of MRI examination,and then regular pathological examination.Follow-up using telephone interview was performed to detect sinus recurrence and reoperation up to April 2017.Results (1) MRI features:① Lesion location:lesions of PPS in 7 patients were located at the presacral areas,top side was up to the third sacral plane,and lower side extended down to the pubic area.② Morphology and signal:sinus tract of 7 patients showed irregular flaky and tubular abnormal signals;fibrotic sinus tract wall showed low signals in T1 weighted imaging (T1WI) and T2WI;contents of sinus tract in 7 patients showed low signal in T1WI and high signals in T2WI and T2WI-fat suppression (T2WI-FS).Of 7 patients,uniform signal and mixed signal were respectively detected in 2 and 5 patients.③ Branches and cystic spaces:1 patient had a branch at the tip of the coccyx,extending to the rear of the sacral vertebra.The top of sinus tract in 4 patients enlarged to form a cavity.④ Signs of infection:signs of infection in 3 patients included blurred and exuded fat gaps around the sinus tract,unclear and partially adhesion with pelvic organ;the pelvic floor muscles in 1 patient were thickened and swollen,with a high signal in T2WI-FS;flaky fluid shadows in 2 patients were seen in the posterior sinus,with a high signal in T2WI-FS,showing a tissue edema of anterior sacrum.⑤ Enhancement features:result of MRI examination of 1 patient showed mild and heterogeneous enhancement of sinus.(2) Treatment and follow-up situations:among 7 patients undergoing sinus resection,2 received curettage of superior sinus due to high location,and 5 received successfully operation.All patients underwent postoperatively regular antibiotic therapy.The healing time was 14-78 days,with an average time of 42 days.The postoperative pathological examination showed different degrees of inflammatory cell infiltration.Seven patients were followed up for 2-74 months,with an average time of 40 months.Of 7 patients,sinus in 6 patients was healed,1 had recurrence of sinus and didn't receive therapy.Seven patients didn't undergo debridement or transposition of skin flap again.Conclusion The MRI imaging features of PPS includes flaky and tubular abnormal signal in the the anterior sacrum,low signal in T1WI,high signals in T2WI and T2WI-FS,and the enhanced scanning of sinus duet shows mild and heterogeneous enhancement.