The Snug Seton: short and medium term results of slow fistulotomy for idiopathic anal fistulae

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
T M HammondP J Lunniss

Abstract

To assess the short and intermediate outcomes of a modification of the traditional cutting seton technique, using a 'snug' silastic seton, to treat idiopathic anal fistulae. Between August 1997 and December 2002, 35 patients with idiopathic fistulae (4 female; age 26-76 years) underwent insertion of a 'snugly' tied 1 mm silastic seton (silicone nerve vessel retractor, Medasil), as definitive treatment. Short-term assessment was performed by case note review. Patients were subsequently invited to participate in a medium-term review. Twenty-nine patients' notes (3 female) were available for short-term analysis. Fistulae were classified as intersphincteric (9) and transsphincteric (20). The seton spontaneously cut out in 15/29 (52%) after a median of 24 weeks. In 14 patients the seton enclosed residual tissue (< 5 mm) required division as a day case procedure, at a median of 35 weeks. All fistulae healed but 10/29 (34%) patients (1 female; 8 transsphincteric) experienced minor incontinence. Sixteen patients participated in a medium-term review at a median of 42 months; 7 had experienced early continence disturbance. No patient suffered recurrence, but minor incontinence persisted in 4/16 (25%) patients (0 females; 3 transsphincter...Continue Reading

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Citations

Feb 25, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Arieh EitanAmitai Bickel
Nov 22, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T M HammondP J Lunniss
Jan 30, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·R D RitchieJ P Hodde
Jan 30, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M L AwadK R Stahlfeld
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