A. Lentner et V. Wienert, LONG-TERM, INDWELLING SETONS FOR LOW TRANSSPHINCTERIC AND INTERSPHINCTERIC ANAL FISTULAS - EXPERIENCE WITH 108 CASES, Diseases of the colon & rectum, 39(10), 1996, pp. 1097-1101
PURPOSE: The purpose of this study was to determine the technique and
results of long-term, indwelling setons for low transsphincteric and i
ntersphincteric anal fistulas. METHOD: Long-term, indwelling setons we
re performed in 108 consecutive patients with low transsphincteric and
intersphincteric anal fistulas. Progress and results of 73.1 percent
of cases were assessed in a retrospective study. RESULTS: Therapy last
ed for an average of 54.8 weeks; mean follow-up was 62 weeks. Relapse
occurred in 3.7 percent of cases and incontinence in 0.9 percent. Aver
age period spent in a hospital was 0.3 days/case. CONCLUSIONS: A long-
term, indwelling seton is a good alternative to primary surgical treat
ment of low transsphincteric and intersphincteric anal fistulas. Relap
se quota is comparable with that of primary surgically treated cases;
incontinence is rarer with long-term, indwelling seton. Complete treat
ment can generally be performed in the outpatient department. One disa
dvantage is that therapy takes much longer than cases treated by prima
ry surgery.