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CC BY 4.0 · Journal of Coloproctology 2024; 44(02): e95-e97
DOI: 10.1055/s-0044-1782628
Original Article

A Composite Seton for the Management of Fistula in Ano

Sujith Philip 
1   Department of Gastrointestinal Surgery, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
,
Geethu Rachel Iype
1   Department of Gastrointestinal Surgery, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
,
Meera Muralee
1   Department of Gastrointestinal Surgery, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
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Abstract

Treatment of fistula in ano by seton has become less in vogue due to the complications and disadvantages associated with its use. In its place, more technically demanding and expensive procedures, with less morbidity but more recurrence, such as endorectal advancement flaps and laser, are being employed more commonly. To overcome some of the limitations of conventional seton, we have designed a composite seton. In the present study, we evaluated our experience with a composite seton made from two silastic vessel loops sutured together with 5-0 polypropylene. The composite seton was found to not present many of the disadvantages of the conventional seton. The use of the composite seton resulted in low incontinence and recurrence rates, less pain, and high quality of life. This technically simple and cheaper material may have a wider applicability.

Keywords

fistula in ano - composite seton


Publication History

Received: 27 May 2023

Accepted: 07 February 2024

Article published online:
06 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Davis BR, Kasten KR. Anorectal abscess and fistula. In: Steele SR, Hull TL, Read TE, Saclarides TJ, Senagore AJ, Whitlow CB. eds. The ASCRS Textbook of Colon and Rectal Surgery. 3rd ed. Vol. 1.. New York: Springer; 2016: 215-44
    Google Scholar
  • 2 Subhas G, Singh Bhullar J, Al-Omari A, Unawane A, Mittal VK, Pearlman R. Setons in the treatment of anal fistula: review of variations in materials and techniques. Dig Surg 2012; 29 (04) 292-300 DOI: 10.1159/000342398.
    CrossrefPubMedGoogle Scholar
  • 3 Pearl RK, Andrews JR, Orsay CP. et al. Role of the seton in the management of anorectal fistulas. Dis Colon Rectum 1993; 36 (06) 573-577 , discussion 577–579
    CrossrefPubMedGoogle Scholar
  • 4 McCourtney JS, Finlay IG. Setons in the surgical management of fistula in ano. Br J Surg 1995; 82 (04) 448-452
    CrossrefPubMedGoogle Scholar
  • 5 Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB. Quality of life with anal fistula. Ann R Coll Surg Engl 2016; 98 (05) 334-338 DOI: 10.1308/rcsann.2016.013.
    CrossrefPubMedGoogle Scholar
  • 6 Ritchie RD, Sackier JM, Hodde JP. Incontinence rates after cutting seton treatment for anal fistula. Colorectal Dis 2009; 11 (06) 564-571
    CrossrefPubMedGoogle Scholar
  • 7 Ege B, Leventoğlu S, Menteş BB, Yılmaz U, Öner AY. Hybrid seton for the treatment of high anal fistulas: results of 128 consecutive patients. Tech Coloproctol 2014; 18 (02) 187-193 DOI: 10.1007/s10151-013-1021-z.
    CrossrefPubMedGoogle Scholar
  • 8 Subhas G, Singh Bhullar J, Al-Omari A, Unawane A, Mittal VK, Pearlman R. Setons in the treatment of anal fistula: review of variations in materials and techniques. Dig Surg 2012; 29 (04) 292-300 DOI: 10.1159/000342398.
    CrossrefPubMedGoogle Scholar
  • 9 Vial M, Parés D, Pera M, Grande L. Faecal incontinence after seton treatment for anal fistulae with and without surgical division of internal anal sphincter: a systematic review. Colorectal Dis 2010; 12 (03) 172-178 DOI: 10.1111/j.1463-1318.2009.01810.x.
    CrossrefPubMedGoogle Scholar