loose Seton in management of high anal fistula

J. Sagban, Nabeel

	loose Seton in management of high anal fistula
Journal of the Faculty of Medicine
Article 1, Volume 57, Issue 2, 2015, Pages 106-108
Author
Nabeel J. Sagban
Abstract
Background : The treatment of complex (high) anal fistulae needs to balance the occasional conflicting outcome of cure and continence. There is a multitude of surgical treatment options available for high fistula-in-ano. The best surgical operation for high anal fistulas is difficult to nominate because they have varying cure and incontinence rates . A loose Seton is a loop of flexible material (silastic tube, silk, nylon) placed through the fistula track to allow drainage by keeping the external skin opening patent . Some surgeons use the loose Seton to allow drainage and others believe that it promotes healing by inducing fibrosis Aim: The efficacy of use of loose Seton in management of high anal fistula. Patient and method: A prospective cohort study of 26 patients with high anal fistula managed by loose Seton placement between February- 2009 and February-2010 in 3rd surgical unit, fifth floor, Baghdad teaching Hospital The seton is removed after 3 months in outpatient clinic, follow up for 6 months. Results: Out of these 26 patients, 23 were males and 3 were females, the male to female ratio was 7.7:1. Peak occurrence was noted between 30 to 40 years. Minor incontinence was noted in two patients, these patients lost control of flatus which persisted for 4 months. No fecal incontinence noticed in any patient. .In twenty one patient the fistula were successfully eliminated (Successful rate =81%) by loose Seton treatment alone, while recurrence fistula in five patients (Failure rate =19%). Conclusion: The use of one stage loose Seton is safe and effective in the treatment of high anal fistula. Key words : Seton , high anal fistula.
Keywords
Seton; high anal fistula

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