Seton treatment of perianal fistula with high anal or rectal opening

✍ Scribed by W. F. Van Tets; Dr. J. H. C. Kuijpers

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 308 KB
• Volume: 82
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800820711

✦ Synopsis

Abstract

Staged fistulotomy with a seton is considered to decrease the high incidence of continence disorders after surgical incision of a fistula. This retrospective study reports the results of the two-stage procedure with special emphasis on faecal continence. Thirty-four patients (aged between 20 and 57 years) were treated between 1981 and 1990 with a two-stage seton procedure for anal fistula (16 extrasphincteric and 18 trans-sphincteric) with a high anal or rectal internal opening. Thirty-one patients had normal preoperative continence. There were two recurrences. All trans-sphincteric fistulas healed. Twenty-nine patients with preoperative normal faecal control were available for follow-up. Postoperative continence was normal in 12 patients (category A according to Browning and Parks classification2): five patients had no control over flatus (B), 11 were incontinent for liquid stool or flatus (C) and one had continued faecal leakage (D). The two-stage seton technique is not recommended for fistulas with high anal or rectal openings.