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Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial
Jalaluddin Khoshnevis1, Roberto Cuomo2, Farzaneh Karami1
1General Surgery Department, Shohadaye Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Summary
The novel "Jump technique" for anal fistula treatment shows promising results, with significantly lower incontinence rates compared to the traditional "Seton technique." This approach offers a potential first-line solution for various fistula types, minimizing complications.
Area of Science:
- Surgical Innovation in Proctology
- Gastrointestinal Surgery Outcomes Research
Background:
- Anal fistula treatment presents surgical challenges with existing methods like fistulotomy, seton, and LIFT often leading to incontinence and recurrence.
- Current surgical options for anal fistula carry significant risks of complications, necessitating exploration of alternative, more effective techniques.
Purpose of the Study:
- To compare the efficacy and complication rates of the novel "Jump technique" versus the established "Seton technique" for treating cryptoglandular anal fistula.
- To evaluate outcomes, specifically focusing on recurrence and incontinence, following surgical intervention for anal fistulas.
Main Methods:
- A randomized controlled trial involving 130 patients with cryptoglandular anal fistula.
- Patients were randomly assigned to either the "Jump technique" (Group A) or the "Seton technique" (Group B).
- Outcomes, including recurrence and incontinence, were assessed one year post-treatment; data analyzed using Fisher Exact, Chi-Square, and Mann Whitney tests.
Main Results:
- The "Jump technique" group (65 patients) reported 12 (20%) recurrences, while the "Seton technique" group (65 patients) reported 10 (15.6%) recurrences.
- Incontinence rates were significantly lower in the "Jump technique" group (3/4.6%) compared to the "Seton technique" group (18/27.7%).
- St. Mark's scores for incontinence showed a significant difference between the two groups, favoring the "Jump technique".
Conclusions:
- The "Jump technique" demonstrates satisfactory results and a potential to obviate common complications associated with anal fistula treatment.
- This technique is suitable as a first-line approach for all types of anal fistulas and can be repeated for recurrent cases without compromising continence.
- The "Jump technique" offers a valuable alternative, potentially allowing for intraoperative technique modification and improved patient outcomes.
