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Horseshoe abscess fistula. Seton treatment
K Ustynoski1, L Rosen, J Stasik
1Division of Colon and Rectinal Surgery, Allentown Hospital, Lehigh Valley Hospital Center, Pennsylvania.
Diseases of the Colon and Rectum
|July 1, 1990
Summary
Seton fistulotomy with counter drainage effectively treats horseshoe abscess fistula, showing a lower recurrence rate than primary fistulotomy. Proper technique and aftercare are crucial for optimal outcomes in managing this complex condition.
Area of Science:
- Colorectal Surgery
- Surgical Innovation
- Anorectal Diseases
Background:
- Horseshoe abscess fistula presents a complex surgical challenge.
- Previous treatments like primary fistulotomy have shown significant recurrence rates.
- Seton fistulotomy with counter drainage offers a potential alternative.
Purpose of the Study:
- To evaluate the efficacy of seton fistulotomy with counter drainage for horseshoe abscess fistula.
- To compare recurrence rates with previous treatment modalities.
- To identify key factors for successful outcomes.
Main Methods:
- A retrospective analysis of patients with horseshoe abscess fistula.
- Comparison of outcomes between primary fistulotomy and seton fistulotomy with counter drainage.
- Detailed discussion of surgical technique and postoperative management.
Main Results:
- Seton fistulotomy with counter drainage demonstrated a recurrence rate of 18.1% in 11 patients.
- This rate is lower than the 28.6% recurrence observed with primary fistulotomy in a prior report.
- No recurrence was noted in an initial subgroup of two patients treated with this method.
Conclusions:
- Seton fistulotomy with counter drainage is the preferred surgical approach for horseshoe abscess fistula.
- Optimal results depend on accurate abscess cavity identification, appropriate seton removal, and diligent postoperative care.
- This technique offers a promising, lower-recurrence treatment option for complex anal fistulas.
