Document Detail


Patient-performed seton irrigation for the treatment of deep horseshoe fistula.
MedLine Citation:
PMID:  20389216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Compared with total fistulotomy using a lay-open technique for treatment of deep horseshoe or deep posterior complex anal fistula, the seton drainage method has reduced damage of the external anal sphincter. However, conventional seton drainage is burdensome to patients, requiring frequent clinic visits for wound management during prolonged periods while the drainage tube is in place. To reduce the number of clinic visits and facilitate healing, we devised a patient-performed seton irrigation technique and compared the results with a conventional loose seton to determine its clinical usefulness. METHODS: We reviewed medical records of 24 patients who were diagnosed with deep horseshoe fistula and underwent surgery between January 1999 and December 2004. Twelve patients treated through December 2001 received a conventional loose seton. Twelve patients treated from January 2002 performed self-irrigation via the seton. These 2 groups were compared regarding duration of purulent discharge, length of time until seton removal, and recurrence rate. RESULTS: The mean duration of purulent discharge was 18.75 (range, 15-24) days for self-irrigation vs 29.75 (24-37) days for conventional loose seton treatment (P < .001). The mean time to removal of the seton was 21.58 (18-29) days for self-irrigation vs 32.58 (28-39) days for conventional treatment (P < .001). The recurrence rate after surgery was 8.3% for self-irrigation vs 16.7% for conventional treatment (P > .99). CONCLUSION: Patient-performed seton irrigation shortens the period of treatment and healing through more effective wound management, and we propose this technique as a useful new method of treating deep horseshoe fistula.
Authors:
Donghwi Choi; Hyun Sung Kim; Hyung-Il Seo; Nahmgun Oh
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  53     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-14     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  812-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Pusan National University School of Medicine, Pusan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Irrigation / methods*
Male
Middle Aged
Rectal Fistula / surgery*
Recurrence
Retrospective Studies
Self Care*
Statistics, Nonparametric
Treatment Outcome
Wound Healing / physiology

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


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