Treatment of Fistula-in-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment PC05-PC08
Dr. Qays A. Hassan,
Instructor, Department of Surgery, Al-Kindy College of Medicine, Baghdad, Iraq.
Introduction: Management of fistula-in-ano is a surgical challenge. Various methods for the treatment of anal fistulas have a range of success rates and use of the cutting seton is still questionable.
Aim: The aim of this study was to assess the effectiveness and suitability of the tight (cutting) seton as a surgical treatment of anal fistula.
Materials and Methods: This was a prospective study of 68 patients (59 males and 9 females) with an anal fistula, mainly of high variety were treated with cutting seton over a 3 year period. Follow up for at least 12 months to record the duration of complete wound healing, fistula recurrence and incontinence was done. Statistical analysis was performed using SPSS version 18.00. A p<0.05 was considered statistically significant.
Results: Complete healing was achieved in 55 patients within 3 months (success rate =80.9%). The treatment was failed in 13 (19.1%) patients. 9 (13.2%) patients have presented minor incontinence 6 (8.8%) with gas incontinence and 3 (4.4%) with liquid stool incontinence and there were no cases of solid stool incontinence. The recurrent fistula was noted in 2 (2.9%) patients during the follow up period.
Conclusion: Cutting seton yields fairly good results in regard to the cure of fistula with good continence in the majority, but the risk of failure or persistence fistula was relatively high so we not recommend the routine use of cutting seton for all anal fistulas.