[Complex anal fistula treated with cutting seton]

Area of Science:

• Colorectal Surgery
• Surgical Management of Fistulas
• Anorectal Diseases

Context:

• Anorectal sepsis, manifesting as abscesses and fistulas, is common in colorectal surgery.
• Complex anal fistulas present a significant management challenge for surgeons.
• The Coloproctology Unit of the General Hospital of Mexico has experience in managing these challenging cases.

Purpose:

• To report the experience of the Coloproctology Unit of the General Hospital of Mexico in managing complex anal fistulas using the cutting seton technique.
• To evaluate the efficacy and outcomes of cutting seton for complex anal fistula treatment.

Summary:

• A retrospective review of 11,731 cases identified 50 patients with complex anal fistulas treated with cutting seton between May 1999 and April 2004.
• The study included patients with high transsphincteric (41), suprasphincteric (8), and high intersphincteric (1) fistulas, with a minimum 6-month follow-up.
• Average seton permanence was 7.02 months, with patients undergoing an average of 4.55 adjustments and 9.67 postoperative examinations.

Impact:

• Cutting seton is an appropriate surgical option for complex anal fistulas, preserving patient continence.
• This technique is particularly useful for high transsphincteric, suprasphincteric, and some extrasphincteric fistulas.
• It is also a viable alternative for women with low anterior transsphincteric fistulas.