Treatment of Fistula-In-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment

Al-Marzooq, Tawfiq Jm; Hassan, Qays A.; Alnaser, Mumtaz Kh.; Al-edani, Mohammed S.

doi:10.7860/jcdr/2017/30017.10822

Cited by 5 publications

(6 citation statements)

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“…25 In 68 patients who had silk cutting seton placement, the average wound healing time was 8 weeks. 26 The seton fall-out time was not presented as it was in any of the other studies, but 75% of the patients stated that wound healing was completed in 8 weeks. 27 The long duration of this study was attributed to the fact that 25% of the participants had Crohn's disease.…”

Section: Discussionmentioning

confidence: 91%

Polypropylene suture as a seton in recurrent fistula-in-ano in lower socioeconomic class-a good option

Patel

2021

Int Surg J

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Background: Recurrent anal fistulas after previous fistula surgery are a unique problem that typically necessitates more anal surgical experience to address the cause of recurrence. The present study was planned with the objective to determine the outcomes of the polypropylene suture as a seton placement for the treatment of recurrent anal fistula.Methods: Patients between the ages of 20-80 years with recurrent fistula-in-ano with single external opening and with history of previous surgery. Patients with preoperative incontinence, patients with difficult follow-up and who were not ready to participate in the study, patients with fistulas caused by inflammatory bowel disease, malignancy, tuberculosis, or trauma, patients with a horseshoe or multiple fistulas, patients with recurrent fistula-in-ano with multiple external opening, or recurrent fistula-in-ano with diseases like Crohn’s disease, tuberculosis, actinomycosis, malignancy, or high level fistula-in-ano without internal opening, and patients with synchronous anorectal problems such as haemorrhoids were excluded.Results: Post-operative pain was observed in all patients while discharge, bleeding and inflammation were observed in 27, 10 and 8 patients, respectively on day 0. Majority of post-operative symptoms were resolves in almost all patients except, pain and discharge were observed in 2 and 1 patients, respectively on day 7. At 6 months follow-up, incontinence of flatus was found out in 2 patients while no patient had incontinence of faeces.Conclusions: Polypropylene suture as a seton in recurrent fistula-in-ano, in previously operated patient is safe and most acceptable treatment. Ksharsutra is not easily available but polypropylene suture is easily available.

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Section: Discussionmentioning

confidence: 91%

Polypropylene suture as a seton in recurrent fistula-in-ano in lower socioeconomic class-a good option

Patel

2021

Int Surg J

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“…19 Al-Marzooq et al in a case series of 55 patients with anal fistula who underwent fistulectomy using tight setons, reported three months recurrence rate of 10.1%. 20 Some points should be kept in mind when deciding on VAAFT, the fistuloscope is a rigid 4.0mm diameter scope, having a length of 18 cm, so it is difficult to pass the scope through a narrow or crooked fistula. 17 The accurate closure of internal opening is another important point; different techniques such as staplers, sutures and advancement flaps are employed, but the ideal closure technique remains controversial.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Recurrence of High Trans-Sphinteric Anal Fistula After Vaaft and Tight Setons in Military Hospital Rawalpindi

Akbar

Bashir²,

Saeedi³

et al. 2022

PAFMJ

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Objective: To compare the recurrence rate in patients undergoing fistulectomy using tight setons with those using videoassisted anal fistula treatment (VAAFT). Study Design: Comparative prospective study. Place and Duration of Study: Department of General Surgery, MH Rawalpindi, Pakistan from May 2018 to Dec 2021. Methodology: We included 200 patients with high trans-sphincteric anal fistula (simple or complex) of age 18 to 60 years, having ASA I or II. Group- A comprised patients undergoing treatment with VAAFT, while Group- B included patients undergoing treatment with Tight Seton in conventional surgery. Patients were followed for three months after the procedure. Patients having a history of discharge around or in the vicinity of the previous external opening of the anal fistula were labelled as having a recurrence. Recurrence was confirmed on MRI Fistulogram. Results: The mean age of patients in Group-A was 42.10±8.26 years, and in Group-B was 42.17±7.91 years (p=0.95). There were 58 male patients in Group-A and 55 male patients in Group-B (p=0.67). The mean duration of the fistula was 5.30±1.64 months in Group-A and 5.22±1.61 months in Group-B (p=0.72). Recurrence was diagnosed in 24 patients in Group-B and only 06 patients in Group-A (p<0.001). Conclusion: Video-assisted anal fistula treatment (VAAFT) has a lower recurrence rate than Tight Setons in conventional surgery in treating high trans-sphinteric anal fistula.

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“…We have also observed a recurrence rate of 2.8% and there was no patient with faecal incontinence after 12 months of follow-up. The other reported incidence rates of incontinence after cutting seton ranged from 0% to 62% ( Table 2 ) ( 1 , 8 , 16 – 19 ). Our data have shown reasonably good results for the preservation of sphincter function.…”

Section: Discussionmentioning

confidence: 98%

“…An anal fistula or fistula-in-ano connects the anorectum to the perineal skin. Fistula-in-ano is one of the most common surgical problems, with an incidence rate of up to 2.8 per 10,000 ( 1 ). Such conditions usually affect men more than women and those affected are most often in their fifth decade of life ( 2 – 5 ).…”

Section: Introductionmentioning

confidence: 99%

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

Ali¹,

Wong²,

Sagap³

2022

MJMS

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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.

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Treatment of Fistula-In-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment

Cited by 5 publications

References 0 publications

Polypropylene suture as a seton in recurrent fistula-in-ano in lower socioeconomic class-a good option

Polypropylene suture as a seton in recurrent fistula-in-ano in lower socioeconomic class-a good option

Comparison of Recurrence of High Trans-Sphinteric Anal Fistula After Vaaft and Tight Setons in Military Hospital Rawalpindi

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

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