Loose Seton: A Misnomer of Cutting Seton

Sungurtekin, Uğur; Ozban, Murat; Erbiş, Halil; Birsen, Onur

doi:10.4236/ss.2016.75030

Cited by 8 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, fistulotomies and fistulectomies produce the best healing rates and have become the standard of treatment. These success rates reflect the fact that the high transsphincteric fistula type is indeed vulnerable to the highest risk of sphincter damage during treatment ( 2 , 3 , 9 , 10 ).…”

Section: Discussionmentioning

confidence: 88%

“…This classification is a means of helping to improve the management plan. Treatment strategies should incorporate a closure of the internal opening and an excision of the infected fistula tract with preservation of the sphincter complex ( 3 , 5 , 8 – 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, a draining seton is a loosely tied seton along the fistula tract that allows for the maturation of the track and drainage of intersphincteric collections. Cutting seton application aims for the preservation of the sphincter through a gradual, staged fistulotomy ( 3 , 8 – 10 ).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery

Ali¹,

Wong²,

Sagap³

2022

MJMS

View full text Add to dashboard Cite

Objectives: We studied the outcome of cutting seton in the treatment of a high transsphincteric anal fistula in Sudan. Methods: This was a prospective study of high transsphincteric anal fistulas at Kassala Police Hospital, Sudan, over the course of 24 months (2016–2017). The main outcomes measured were recurrence, incontinence and primary healing rates. Results: The cases of 72 patients treated with cutting seton for high transsphincteric fistula were analysed, with 50 (70%) of the patients being male and 22 (30%) being female. Forty-eight (66.7%) patients required two sessions of seton tightening with a duration of seton treatment of 30 days and 24 (33.3%) patients required three sessions with a duration of seton treatment of 45 days. Only one patient (1.4%) had flatus incontinence. Three (4.2%) patients had minimal bleeding from the seton site and two (2.8%) patients experienced fistula recurrence. Twenty-six (36%) patients achieved complete healing within 30 days, while 36 (54.3%) patients healed within 60 days. The remaining seven (9.7%) patients healed after 60 days. Chronic pain was reported by two (2.8%) patients after complete healing. Conclusion: In Sudan, cutting seton remains relevant, as it produces minimal incontinence with a low recurrence rate in high transsphincteric fistula treatment.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery

Ali¹,

Wong²,

Sagap³

2022

MJMS

View full text Add to dashboard Cite

show abstract

“…Lay the fistulous track widely open or to excise it completely are termed as Fistulotomy or Fistulectomy respectively to ensure that the wound heals from the depth outwards. 29 This is the best and highly suggested technique since the Muslim era for Nasoore Nafiz (low anal fistulas). To do this procedure, the patient is asked to lie down supine in Lithotomy position.…”

Section: Fistulotomy or Fistulectomymentioning

confidence: 99%

Concept of Fistula in Ano (Nasoore-E-Maqad) and Its Management in Unani System of Medicine

Najar¹,

Ss²,

Ahmad³

et al. 2018

J Biol Sci Opin

View full text Add to dashboard Cite

The perianal fistula is one of the most frustrating problems and its management is still a challenge for surgeons. It is first described by great Unani Physician Hippocrates around 400 BC. Hippocrates not only described the pathophysiology, clinical presentations and the management of Fistula in Ano but also explain the goal of the treatment which is the obliteration of the fistulous tract without hampering the continence. After Hippocrates, there are many surprising and amazing advancement made by the Arab scholars mainly by the great Unani surgeon Abulqasim Al-Zahrawi. Besides the use of Setons, He explained many other surgical techniques for the management of the perianal fistulas for example Amal-e-Kharam (a modified form of the cutting seton), Fistulotomy or Fistulectomy and Cauterizations etc. Because no single procedure is appropriate for all type of fistulas, so it must be treated according to the clinical presentations, patient's conditions, degree of the involvement of the anal sphincters and the surgeon's experiences etc. Centuries passed many new and advanced techniques are developed for the management of perianal fistulas but the basic principle remains constant i.e. Obliteration of the fistulous track without hampering the continence. The aim of this paper is to evaluate and validate the classical techniques for the management of perianal fistulas explained by Unani scholar which are still in practice and considered as newer and advanced procedures crediting or thanking the Unani surgeons.

show abstract

Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence

Schrader,

Brandstrup,

Olaison

2023

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose To investigate the ability of a “slowly cutting, loose seton ligature and staged fistulotomy” to heal perianal fistulas, the time needed with the seton ligature, recurrence rate, influence on anal continence, health-related quality of life (HRQoL), and patient satisfaction. Methods Observational single-center study. We reviewed the medical records of all patients with primary surgeries from January 1, 2009, to December 31, 2018. The patients answered a questionnaire pre- and postoperative on anal continence (St. Mark’s incontinence score) and HRQoL (The Short Health Scale). Satisfaction with the operation was answered postoperatively. Results Forty-three patients (37 men, 6 women) were included. Initially 41 of 43 healed (95%). Three patients (7%) had a recurrence, two healed after retreatment. The median follow-up was 55 months (IQR, 4). Thirty-four patients (79%) responded to the questionnaire. At follow-up, forty (93%) patients were healed. The median time treated with a seton ligature in the healed patients was 13 months (IQR, 14). St. Mark’s incontinence score preoperative was median 2 (IQR, 9) and after the operation median 1 (IQR, 4). The Short Health Scale improved from median 20 (IQR, 5) preoperatively to 5 (IQR, 5) postoperatively, p < 0.001. Patient satisfaction was median 1 (= very satisfied) (IQR, 1). Conclusion A “slowly cutting, loose seton ligature followed by a staged fistulotomy”, heals the vast majority of perianal fistulas with minor or none influence on continence and few recurrences. Patient-reported HRQoL improves greatly, and patient satisfaction is high.

show abstract

Loose Seton: A Misnomer of Cutting Seton

Cited by 8 publications

References 15 publications

The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery

The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery

Concept of Fistula in Ano (Nasoore-E-Maqad) and Its Management in Unani System of Medicine

Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence

Contact Info

Product

Resources

About