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[Anal fistula treatment with seton]
J Gonzálvez Piñera1, A Marco Macián, M S Fernández Córdoba
1Sección de Cirugía Pediátrica, Complejo Hospitalario Universitario de Albacete, C/Hermanos Falcó s/n, 02006 Albacete.
Summary
Cutting setons offer a simple and effective treatment for pediatric anal fistulas. This outpatient method successfully eradicated fistulas in children with no reported incontinence or recurrence after 12 months.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Context:
- Anal fistulas in children require treatment to manage sepsis and preserve sphincter function.
- Traditional treatments like fistulotomy and fistulectomy carry risks.
- Alternative methods include various seton techniques.
Purpose:
- To evaluate the efficacy and safety of the progressive fistulotomy technique using a one-stage cutting seton for treating trans-sphincteric anal fistulas (Parks type 2) in children.
- To assess outcomes regarding sepsis drainage, tract eradication, sphincter function, complications, and recurrence.
Summary:
- Six pediatric cases of trans-sphincteric anal fistula (Parks type 2) were treated using a one-stage cutting seton as an outpatient procedure without general anesthesia.
- The technique involved progressive division of the sphincter muscle over 18-27 days.
- Complete fistula healing was achieved with no instances of incontinence or other complications.
Impact:
- The cutting seton technique provides a simple, effective, and safe treatment option for pediatric anal fistulas.
- This method demonstrates low complication rates and no recurrence at 12-month follow-up.
- It offers a viable alternative for managing complex pediatric anal fistulas, preserving sphincter function.