Long‐term outcome of loose seton for complex anal fistula: a two‐centre study of patients with and without Crohn’s disease

Galis-Rozen, E.; Tulchinsky, Hagit; Rosen, Ada; Eldar, Samuel; Rabau, Micha; Stepanski, A.; Klausner, Joseph M.; Ziv, Yaron Bar

doi:10.1111/j.1463-1318.2009.01796.x

Cited by 52 publications

(40 citation statements)

References 13 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recurrence rates around 25% -80% have been reported in the literature with using long-term loose-seton techniques for complex perianal fistula [1] [12]. Although follow-up ranged between 12 -36 months (mean, 25 months), there were no recurrences in our study This may be criticized, since the follow-up time was relatively short, but most of the recurrences occur in the first two-year period postoperatively.…”

Section: Discussioncontrasting

confidence: 52%

“…Therefore, this technique recommended reduced postoperative anal incontinence in the literature. Loose seton is defined as a ligature made from any type of material placed in the fistulous track around the anal sphincter and tied without tension [1] [2]. The aim of the study is to analyze the effect of loose Seton technique for cryptogenic originated in high transsphincteric anal fistula, on the results of recurrence and its effect on anal pressure changes and postoperative anal incontinence.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Loose Seton: A Misnomer of Cutting Seton

Sungurtekin¹,

Ozban²,

Erbiş³

et al. 2016

View full text Add to dashboard Cite

Purpose: The purpose of this study was to demonstrate loose silk seton actually acts as a slow cutting seton contrary to the idea of simply drainage. Besides, to show the effect of loose seton on patient's incontinence is mostly proportional to the degree of division of the sphincter muscle. Design: Fifty patients with high transsphincteric fistulas were treated with loose seton technique. We measured the length of high sphincteric fistula tracts, pre-and postoperative anal sphincter pressures and incontinence scores. Results: Loose seton with heavy silk resulted in 72% percent of progressive migration of the fistula tract caudally. The more the progressive migration of the loose seton loop, the less the pressure drop in both resting and squeezing in manometric studies. This study is limited by its retrospective design in prospectively collected data and covers relatively small number of patients. Conclusion: Seton is still useful technique in high perianal fistula surgery. Defining this technique as simply "loose" seton is misnomer since it acts as a slowly cutting seton and results in progressive migration of the fistula tract caudally. The more the progressive migration of the loose seton loop, the less the pressure drop would be possible after postoperatively.

show abstract

Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Loose Seton: A Misnomer of Cutting Seton

Sungurtekin¹,

Ozban²,

Erbiş³

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Although the cutting seton at one time was thought to preserve continence in comparison with direct division, reports have not confirmed this reputed advantage. Minor disturbance of continence occurs in 34-63 % of patients along with impaired anal manometry and postoperative deformity of the anal canal [41,48]. Additionally, cutting setons are not well tolerated because of the discomfort associated with frequent tightening of the cutting seton.…”

Section: Fistulotomymentioning

confidence: 97%

Incontinence After Lateral Internal Sphincterotomy/Fistulotomy

Rossi

Rothenberger

2015

Gastrointestinal Surgery

View full text Add to dashboard Cite

“…Palliation can be achieved with placement of a noncutting seton, thereby providing continuous drainage and control of local sepsis. Healing can be achieved in 48%-100% of patients without any other intervention other than removal of the seton when sepsis resolves, 25,[35][36][37] with a median time to seton removal ranging from 3-58 months. However, recurrence is common, with long-term (median of 142 months) relapse rates as high as 90%.…”

Section: Anorectal Diseasementioning

confidence: 98%

Surgical management of pyogenic complications of Crohnʼs disease

Cellini

Safar

Fleshman

2010

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

Patients with Crohn's disease are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. Complications in these 2 distinct areas are managed differently; however, they are similar in the fact that initial treatment relies on medical or minimally invasive management to achieve a nonacute condition prior to definitive surgical procedure. This article reviews the current surgical management of obtaining pyogenic control in both anorectal and intraabdominal Crohn's disease.

show abstract

Long‐term outcome of loose seton for complex anal fistula: a two‐centre study of patients with and without Crohn’s disease

Abstract: The fistula recurrence rate following two-stage seton fistulotomy in non-CD patients was high. In CD patients the use of permanent loose seton is effective in controlling local sepsis in about half of patients and has low rates of subsequent incontinence.

Cited by 52 publications

References 13 publications

Loose Seton: A Misnomer of Cutting Seton

Loose Seton: A Misnomer of Cutting Seton

Incontinence After Lateral Internal Sphincterotomy/Fistulotomy

Surgical management of pyogenic complications of Crohnʼs disease

Contact Info

Product

Resources

About