title: Functional results after seton treatment of high transsphincteric anal fistulas.
abstract: OBJECTIVE
  To evaluate the functional outcome after seton treatment of high transsphincteric anal fistulas.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital, Sweden.
  
  
  METHODS
  29 patients (8 women, mean age 46, range 25-71) with high transsphincteric anal fistulas 1983-1992.
  
  
  METHODS
  Setons were inserted in the anal fistulas in all patients.
  
  
  METHODS
  Anal continence evaluated by a questionnaire a mean of 46 months postoperatively. Clinical data were collected from the patients' records.
  
  
  RESULTS
  All four patients with inflammatory bowel disease had some incontinence. Of the remaining 25 patients, 11 (44%) complained of incontinence and 2 (8%) developed recurrent fistulas. Incontinence was more common when the seton was tightened at the last procedure (7/9) compared with those in which the tissue enclosed by the seton was divided (4/16, p = 0.03). No other preoperative or operative characteristic significantly influenced the risk of incontinence.
  
  
  CONCLUSIONS
  Incontinence is common after seton treatment of high transsphincteric anal fistulas. The risk seems to be higher when the muscle remains viable after a period of seton treatment.
authors.affiliation: Department of Surgery, Akademiska sjukhuset, Uppsala, Sweden.
authors.forename: W
authors.initials: W
authors.lastname: Graf
authors.forename: L
authors.initials: L
authors.lastname: Påhlman
authors.forename: S
authors.initials: S
authors.lastname: Ejerblad
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000502:physiology* / Q000601:surgery; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011183:Postoperative Complications; D012003:Rectal Fistula / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D011091:Polyesters