LONG-TERM, INDWELLING SETONS FOR LOW TRANSSPHINCTERIC AND INTERSPHINCTERIC ANAL FISTULAS - EXPERIENCE WITH 108 CASES

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.