Cutting seton without preliminary internal sphincterotomy in management of complex high fistula-in-ano

Diseases of the Colon and Rectum
J S McCourtney, I G Finlay

Abstract

The traditional treatment of a complex high fistula-in-ano by internal sphincterotomy and insertion of a cutting seton carries a risk of fecal incontinence. We have assessed the functional impact of treating patients with a complex fistula-in-ano by a cutting seton fistulotomy technique that preserves the internal sphincter. The operative steps consisted of initial eradication of sepsis, identification of the internal and external openings of the fistula tract, excision of the fistula tract with anal canal mucosa, and insertion of a cutting silk seton around both the internal and external sphincters. In this way open drainage of the intersphincteric space was avoided, and integrity of the internal sphincter was maintained. Functional outcome following treatment with this technique, with regard to fistula eradication and effect on fecal continence was assessed in 27 patients (15 males) who were treated during a six-year period. Twenty-three patients (85 percent) had a history of previous fistula surgery. The fistula was cured in 26 patients (96 percent) with no reports of altered continence at the time of discharge from outpatient review. Recurrence developed in one patient (4 percent) in whom hidradenitis suppurativa was subseq...Continue Reading

References

Apr 1, 1978·Annals of Surgery·P H Hanley
Sep 1, 1976·Diseases of the Colon and Rectum·A G Parks, R W Stitz
Mar 1, 1992·The British Journal of Surgery·F Seow-Choen, R J Nicholls
Oct 1, 1991·The British Journal of Surgery·J G WilliamsS M Goldberg
Oct 1, 1990·The British Journal of Surgery·P Lewis, D C Bartolo
Dec 1, 1990·International Journal of Colorectal Disease·J M Stone, S M Goldberg
Nov 1, 1988·The British Journal of Surgery·M C Misra, B M Kapur
Feb 1, 1988·Diseases of the Colon and Rectum·R K Reznick, H R Bailey
Jan 1, 1988·Diseases of the Colon and Rectum·E I ShemeshD M Neufeld
May 1, 1987·The British Journal of Surgery·J WedellL Kleine
Dec 1, 1987·Diseases of the Colon and Rectum·I T JonesD G Jagelman
Jul 1, 1986·Diseases of the Colon and Rectum·A ChristensenJ Christiansen
Feb 1, 1985·The British Journal of Surgery·C V Mann, M A Clifton
Jul 1, 1985·Diseases of the Colon and Rectum·P S AguilarW R Stewart
Mar 1, 1981·American Journal of Surgery·S SlutzkiH Bogokowsky
Mar 1, 1983·Diseases of the Colon and Rectum·P BelliveauA G Parks
Jun 1, 1993·The British Journal of Surgery·D MatosR K Phillips

❮ Previous
Next ❯

Citations

Oct 17, 2009·Inflammatory Bowel Diseases·Hussila KeshawRichard M Day
Nov 26, 2009·Diseases of the Colon and Rectum·Neil HymanTurner Osler
Oct 9, 2009·Techniques in Coloproctology·L K BrowderA M Kaiser
Feb 24, 2004·Diseases of the Colon and Rectum·Rasmy LoungnarathJames W Fleshman
Dec 29, 2004·Diseases of the Colon and Rectum·Andreas KoehlerSotirios Athanasiadis
Jun 7, 2005·Diseases of the Colon and Rectum·Andrew P Zbar, Mario Pescatori
Aug 1, 2009·The Indian Journal of Surgery·Gautam ChatterjeeSaurav Chakravartty
Jun 5, 2013·Updates in Surgery·Andrea Cariati
Dec 14, 2011·Diseases of the Colon and Rectum·Andrew P Zbar, Marat Khaikin
Apr 25, 2006·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T M HammondP J Lunniss
Oct 27, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J G WilliamsB D George
Jan 30, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·R D RitchieJ P Hodde
Dec 1, 2011·Drug Delivery and Translational Research·Hairui LiLifeng Kang
Jan 30, 2010·The Surgical Clinics of North America·Julie A RizzoEric K Johnson
Sep 18, 2008·ANZ Journal of Surgery·Shing WongKevin Ooi
Jun 19, 2010·ANZ Journal of Surgery·David Z Lubowski
May 23, 2015·ANZ Journal of Surgery·Vicki PattonDavid Lubowski
Jun 5, 2003·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H. A Joy, J. G Williams
Sep 6, 2000·The British Journal of Surgery·D M Hemingway, I G Finlay
Jul 16, 2005·Health Care for Women International·Wilfreda E ThurstonErin Rutherford
May 18, 2001·Diseases of the Colon and Rectum·W H Isbister, N Al Sanea
May 24, 2006·World Journal of Gastroenterology : WJG·Ismail Sagap, Feza-H Remzi
May 14, 2010·The Cochrane Database of Systematic Reviews·Tarun J JacobMichael R B Keighley
Mar 30, 2005·Gastroentérologie Clinique Et Biologique·Philippe Godeberge
Feb 16, 2006·Cirugía española·Enrique CasalJosé Pampin

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.