Decanini-Terán CO, Hagerman-Ruiz GG, Belmonte-Montes C, Chiapa-Cortés M, Hernández-Alejandro R

Language: Spanish
References: 15
Page: 428-431
PDF size: 30.19 Kb.

ABSTRACT

Purpose: This study was undertaken to evaluate the success of a different method of placing the cutting Seton in treatment of anorectal fistulas. This treatment consisted of placement of a Seton without carrying out a cut in the internal or external anal sphincter and effecting a slow adjustment, evaluating its impact on recurrence and incontinence. Methods: A retrospective review of all patients with diagnosis of anorectal fistulas of cryptoglandular origin admitted to the American British Cowdray Medical Center, IAP in Mexico City who had Seton placement as treatment during a period from January 1992 to December 1997 who were included, for a total of 42 patients, 31 men and 11 women. The Seton was put in place in the operating room and the internal anal sphincter was left untouched. Adjustments were initiated 3 weeks after initial procedure depending on patient tolerance. Post-operative continence and recurrence state were evaluated by telephone call carried out by a third party not involved in the study. Results: Forty two patients were included, 31 men and 11 women, with mean age of 43.6 years (range 28-70 years) and average follow-up of 33.65 months (range 9-65 months), 10 intersphincteric fistulae with mean time with Seton of 9.7 weeks, 13 low transphincterics with average of 10.1 weeks, 11 high transphincterics, mean time 10.7 weeks, and eight recurrent fistulae with an average of 18.2 weeks. All fistulas healed, there were no recurrences, and no patient presented incontinence. Treatment of anorectal fistulae with cutting Setons offers a good option with no incontinence or recurrences observed secondary to very slow adjustment of the Seton.

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