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Updated: May 7, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term results of seton placement for fistula-in-ano in infants
Mikiya Inoue1, Kiminobu Sugito, Taro Ikeda
1Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan.
Insights
Seton placement effectively treats fistula-in-ano (FIA) in infants, demonstrating high long-term success rates. This surgical approach offers a viable option for managing this condition in young children.
Area of Science:
- Pediatric Surgery
- Anorectal Disorders
Background:
- Fistula-in-ano (FIA) is a challenging condition in infants.
- Long-term outcomes of seton placement for FIA in this age group require further assessment.
Purpose of the Study:
- To evaluate the long-term efficacy of seton placement for treating fistula-in-ano in infants.
Main Methods:
- Retrospective review of infants (<1 year) treated for perianal abscess (PA) and/or FIA.
- Exclusion of patients with systemic or inflammatory bowel diseases.
- Standard initial treatment for PA was incision and drainage; seton placement for FIA.
Main Results:
- Of 90 infants with available follow-up, 36 (40%) developed FIA and underwent seton placement.
- A cutting seton achieved fistula healing in 35 of 36 patients (97.2%) within a mean of 6.3 weeks.
- One patient with recurrence achieved successful healing after a second seton placement.
Conclusions:
- Seton placement demonstrates high long-term success in treating infant fistula-in-ano.
- This procedure should be considered a valuable treatment option for pediatric FIA.
Background:
The present study aimed to assess the long-term results of seton placement for fistula-in-ano (FIA) in infants.
Methods:
Data of patients aged <1 year who presented to our department with perianal abscess (PA) between January 2006 and February 2010 were retrospectively reviewed. Our standard initial treatment for PA was incision and drainage. Patients with systemic diseases and inflammatory bowel diseases were excluded.
Results:
Ninety-five patients were treated for PA and/or FIA during the 5-year period, and follow-up data were available for 90 patients. The mean follow-up duration in these patients was 49.8 ± 11.4 months, and mean age at presentation was 3.1 ± 2.7 months. Of the 90 patients, 36 (40%) developed FIA (39 lesions) and underwent seton placement. The condition healed in a mean period of 6.3 ± 4.0 weeks after the placement of a cutting seton. Healing of the fistula was achieved in 35 (97.2%) of 36 patients after the initial seton procedure, and one patient who showed recurrence underwent a second seton placement, resulting in successful healing of the FIA after 5 weeks.
Conclusions:
The long-term success of seton placement indicates that this procedure should be a treatment option for FIA in infants.
