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To examine the lining of the IFT with special interest in thepresence of epitheliarisation and anal gland tissue as it has recently been reported that trans-sphincteric fistulae can be treated by ligation of the intersphincteric fistula track (LIFT). Thepromising results of this LIFT-procedure suggest that the intersphincteric fistula track (IFT) might be the source of ongoing disease resulting in persistence of the fistula. Histopathology of the IFT mayprovide evidence for this assumption.A consecutive series of ten patients with a high trans-sphincteric perianal fistula of cryptoglandular origin underwent ligation of the IFT. The central part of the IFT was excised. Histopathological examination of the IFT regarding lining and anal gland tissue was performed by a pathologist blinded for clinical data.Epithelial lining of the IFT was found in only two patients (20%). In both patients the epitheliarisation was complete. In none of the patients anal gland tissuepresent.Anal gland tissue is absent in IFT. The lining of most IFT's consists of granulation tissue. Epitheliarisation is rare. These findingsprovide no explanation for thepromising results of the LIFT-procedure.