Treatment of fistula-in-ano in infants with a seton

Ikeda, Taro; Inoue, Masatoshi; Sugitou, Kiminobu; Hagiwara, Noritsugu; Koshinaga, Tugumichi; Kusafuka, Takeshi

doi:10.1016/j.jpedsurg.2007.01.062

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Besendörfer et al 10.3389/fsurg.2023.1144425 rate with increasing age, regardless of the therapeutic approach (12), which contradicts our results. However, the bias of this uneven distribution regarding only nine patients in the age group of children impedes to draw strong conclusions.…”

Section: Discussioncontrasting

confidence: 90%

“…Inoue et al presented the long-term follow-up of these patients in 2014 and confirmed that fecal incontinence could be excluded as a relevant sequela with a mean follow-up time of 50 months (11). Conclusively, they confirmed a decreased recurrence rate and treatment duration after cutting seton placement in 36 FIA patients aged <1 year (10). Direct comparison to non-cutting techniques should be made with caution and might only be completely possible if the scientific discussion is focusing on infancy/childhood data on pain (postsurgically and after tightening of the seton to cut further), quality of life, and long-term follow-up of fecal incontinence (>40 years of age).…”

Section: Discussionmentioning

confidence: 82%

“…Besendörfer et al 10.3389/fsurg.2023.1144425 observable between 6 and 12 weeks, when epithelialization of the fistulous tract had been achieved. Seton placement as a therapeutic option in pediatric FIA has rarely been discussed in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Seton placement as a therapeutic option in pediatric FIA has rarely been discussed in the literature. Ikeda et al were able to publish the first study presenting the outcome of FIA patients after cutting seton placement, which is considered the largest series on cutting seton placement in children ( 10 ). Of the FIA patients, 97% recovered under therapy with seton.…”

Section: Discussionmentioning

confidence: 99%

“…Besendörfer et al10.3389/fsurg.2023.1144425 associated with the occurrence of recurrent FIA or perianal abscess (p = 0.8893). Overall, FIA recurrence rate was at 7% (3/42) within an observational time of 9 months postsurgically: in two patients, an FIA occurred at 1.0 and 3.5 months while the seton was still in place, which made surgical revision necessary.…”

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confidence: 96%

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Treatment of pediatric fistula-in-ano—Sphincter-sparing non-cutting seton placement as the future treatment of choice?

et al. 2023

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BackgroundTherapeutic principles of fistula-in-ano (FIA) are lacking evidence-based consensus on treatment options. Non-cutting, sphincter-sparing options have not been published for infancy and childhood FIA.Patients and methodsWe are presenting retrospective data on FIA treatment with non-cutting seton placement between 2011 and 2020. Data were collected based on medical records and complemented by patients’ contact for follow-up analyses between November 2021 and October 2022. Data were analyzed regarding the outcome variables of recurrent FIA and recurrent perianal abscess. Furthermore, outcomes in different age groups were compared (<1/1.5–12 years of age).ResultsTreatment duration with non-cutting seton was at a median of 4.6 months and was not associated with recurrent FIA (p = 0.8893). Overall recurrence rate of FIA within an observation time of 9 months postsurgically was at 7% (n = 3/42) and was only seen in infancy, whereas recurrent perianal abscess was mainly observable in children (n = 2, p = 0.2132). Comparison of age groups revealed no significant differences. Of the 42 included patients, 37 responded in the follow-up analysis, resulting in a response rate of 88% with a median follow-up time of 4.9 years. Fecal incontinence was postsurgically only seen in two patients, who were diagnosed prior to surgery and symptoms remained unchanged.ConclusionsNon-cutting seton placement might be a promising option in the treatment of FIA in infancy and childhood. Perioperative settings like duration of placed seton and antibiotic treatment have to be discussed in further prospective, enlarged population-based studies.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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