Incontinence rates after cutting seton treatment for anal fistula

Abstract

Objective To determine the incidence of anal incontinence after the use of cutting seton treatment for anal fistula.Method Literature searches were performed on PubMed, MEDLINE and Google Ô Scholar using the words 'cutting seton(s)', 'seton(s)' and 'anal fistula'. An analysis of the data in the collected references was performed.Results The average rate of incontinence following cutting seton use was 12%. The rate of incontinence increased as the location of the internal opening of the fistula moved more proximally. In the studies that described the types of incontinence, liquid stool was the most common followed closely by flatus incontinence. Incontinence associated with the treatment of fistulas defined as nonspecific cryptoglandular in nature was 18%.Conclusion The high incontinence rates that result from the use of cutting setons suggest that this commonly used therapy can damage the continence musculature. Other techniques that do not involve cutting the sphincter, when available, should be preferred, especially for higher fistulas.

Evaluation of the Cutting Seton Technique in Treating High Anal Fistula

“…Worldwide, the incontinence rate after anal fistula surgical management using various types of medical materials for the seton varies from 0% to 62%. Additionally, the recurrence rate is reported to range from 2.4% to 16% [2,16], which aligns with our study's findings. Similar results were also reported by a Saudi study, which showed a 2.4% rate of fistula-inano recurrence [2].…”

Evaluation of the Cutting Seton Technique in Treating High Anal Fistula

“…Worldwide, the incontinence rate after anal fistula surgical management using various types of medical materials for the seton varies from 0% to 62%. Additionally, the recurrence rate is reported to range from 2.4% to 16% [2,16], which aligns with our study's findings. Similar results were also reported by a Saudi study, which showed a 2.4% rate of fistula-inano recurrence [2].…”

Autologous skin graft intersphincteric implantation in anal fistula treatment ( ASGIIFT ) – A novel surgical technique in the treatment of complex transsphincteric anal fistulas

“…These findings align with previous studies emphasising that preservation of the sphincter complex is critical for maintaining postoperative function [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Notably, the average healing time observed in this study was shorter than in our previously published studies, decreasing from 6 to 4 weeks [21].…”

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients

“…In our study, 58 patients (15.6%) complained of transient incontinence for flatus, which disappeared in 2 weeks in all patients. No fecal incontinence was recorded in any patient, a finding that correlates with the results of many other international studies [ 1 , 6 , 10 ].…”

Evaluation of the Cutting Seton Technique in Treating High Anal Fistula

“…Worldwide, the incontinence rate after anal fistula surgical management using various types of medical materials for the seton varies from 0% to 62%. Additionally, the recurrence rate is reported to range from 2.4% to 16% [2,16], which aligns with our study's findings. Similar results were also reported by a Saudi study, which showed a 2.4% rate of fistula-inano recurrence [2].…”

Autologous skin graft intersphincteric implantation in anal fistula treatment ( ASGIIFT ) – A novel surgical technique in the treatment of complex transsphincteric anal fistulas

“…These findings align with previous studies emphasising that preservation of the sphincter complex is critical for maintaining postoperative function [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Notably, the average healing time observed in this study was shorter than in our previously published studies, decreasing from 6 to 4 weeks [21].…”

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients

“…In our study, 58 patients (15.6%) complained of transient incontinence for flatus, which disappeared in 2 weeks in all patients. No fecal incontinence was recorded in any patient, a finding that correlates with the results of many other international studies [ 1 , 6 , 10 ].…”

Evaluation of the Cutting Seton Technique in Treating High Anal Fistula

“…Worldwide, the incontinence rate after anal fistula surgical management using various types of medical materials for the seton varies from 0% to 62%. Additionally, the recurrence rate is reported to range from 2.4% to 16% [2,16], which aligns with our study's findings. Similar results were also reported by a Saudi study, which showed a 2.4% rate of fistula-inano recurrence [2].…”

Autologous skin graft intersphincteric implantation in anal fistula treatment ( ASGIIFT ) – A novel surgical technique in the treatment of complex transsphincteric anal fistulas

“…These findings align with previous studies emphasising that preservation of the sphincter complex is critical for maintaining postoperative function [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Notably, the average healing time observed in this study was shorter than in our previously published studies, decreasing from 6 to 4 weeks [21].…”

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients

“…In our study, 58 patients (15.6%) complained of transient incontinence for flatus, which disappeared in 2 weeks in all patients. No fecal incontinence was recorded in any patient, a finding that correlates with the results of many other international studies [ 1 , 6 , 10 ].…”