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[Treating high anal fistulae with slow cutting seton]
Anna Lykke1, Joen Steendahl, Peer A Wille-Jørgensen
1Kirurgisk Afdeling K, Bispebjerg Hospital, DK-2400 København NV, Denmark. annalykke@dadlnet.dk
Ugeskrift for Laeger
|February 17, 2010
Summary
Slow-cutting setons for anal fistula repair show high patient satisfaction but also a significant rate of anal incontinence. Alternative non-invasive treatments are recommended for initial therapy.
Area of Science:
- Colorectal surgery
- Gastroenterology
- Surgical outcomes
Context:
- Transsphincteric anal fistulas present a surgical challenge.
- Seton placement is a common treatment modality.
- Evaluating treatment efficacy and patient-reported outcomes is crucial.
Purpose:
- To assess the incidence of anal incontinence, recurrence rates, and patient satisfaction following slow-cutting seton use for transsphincteric anal fistula repair.
Summary:
- A retrospective study followed 41 patients treated with slow-cutting setons for transsphincteric anal fistulas.
- Post-treatment assessment revealed a 12% recurrence rate and significant incontinence in 61.7% of patients (Wexner score ≥1).
- Despite incontinence, 82% of patients reported high satisfaction, with no correlation between satisfaction and incontinence severity.
Impact:
- The high rate of incontinence suggests non-invasive techniques may be preferable as first-line treatment for anal fistulas.
- Slow-cutting setons may be a viable option for complex cases or after failed previous attempts.
- Findings guide treatment selection and patient counseling for anal fistula management.
