SETON TREATMENT OF ANAL FISTULA - EXPERIENCE WITH A NEW MODIFICATION

Objective: To describe a modified method of seton treatment of anal fi stula. Design: Retrospective study. Setting: Teaching hospital, Poland . Subjects: 33 patients operated on for anal fistulas between January 1992 and September 1996. Interventions: A modified seton technique in which a rubber band was pulled through fistulous track and tightened a round the external sphincter by a thread tied around its ends. Main ou tcome measures: Anal incontinence, fistula recurrences. Results: Of th e 33 patients, 22 had high trans-sphincteric, 4 had suprasphincteric, and 7 had extrasphincteric fistulas. No fistula recurred. All patients were sent a questionnaire and 32 replied (97%). 26 patients had norma l control of solid stool. 1 was incontinent less than once a week, and 5 less than once a month. 20 patients were continent to liquid stool. 3 patients experienced problems controlling liquid stool less than on ce a week, and 9 less than once a month. 21 patients had normal contro l of flatus. 9 experienced minor soiling. Conclusion: The method is si mple, therapeutic results are satisfactory, and patients tolerate the procedure well. We recommend it in any case in which total fistulectom y cannot be done because of the risk of incontinence.