Document Detail

Cutting seton for complex anal fistulas.
MedLine Citation:
PMID:  18581757     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A standardised protocol for performing a cutting seton has not been well described in the existing literature. The aim of this study was to examine our experience of treatment of complex anal fistulas by cutting seton over 15 years in our hospital, detailing surgical technique, results and complications. METHODS: Between 1990 and 2004, 112 patients with complex anal fistulas were treated by applying cutting setons in our hospital. The elastic band from a surgical glove was used as the seton material. The seton was re-tightened for the first time in the second week after the initial operation and then at weekly intervals. RESULTS: There were 98 male and 14 female patients, with a median age of 43 years. Eighty-four patients had trans-sphincteric or suprasphincteric fistulas, and 28 patients had extrasphincteric fistulas. The mean operative time was 42 minutes. The mean number of seton ties was 3-3 times. The mean duration with the seton in place was 28.7 days. The mean time of the wound healing was 9.3 weeks. Median period of follow-up was 38.6 months. Recurrence was found in one patient (0.9%). Twenty-seven patients (24.1%) were noted with continence disorders, including gas incontinence in 21 patients (18.6%) and liquid stool incontinence in 6 patients (5.4%). There were no incidents of solid stool incontinence. CONCLUSIONS: Using the elastic band from a surgical glove as a seton with repeated tightening at weekly intervals is safe and effective, with shorter duration of wound recovery, low recurrence and less continence disorders.
C Chuang-Wei; W Chang-Chieh; H Cheng-Wen; L Tsai-Yu; F Chun-Che; J Shu-Wen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland     Volume:  6     ISSN:  1479-666X     ISO Abbreviation:  Surgeon     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-27     Completed Date:  2008-09-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101168329     Medline TA:  Surgeon     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  185-8     Citation Subset:  IM    
Division of Colon and Rectal Surgery, Department of Surgery, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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MeSH Terms
Cohort Studies
Gloves, Surgical*
Ligation / instrumentation
Middle Aged
Rectal Fistula / surgery*
Suture Techniques / instrumentation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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