title: Seton treatment of perianal fistula with high anal or rectal opening.
abstract: Staged fistulotomy with a seton is considered to decrease the high incidence of continence disorders after surgical incision of a fistula. This retrospective study reports the results of the two-stage procedure with special emphasis on faecal continence. Thirty-four patients (aged between 20 and 57 years) were treated between 1981 and 1990 with a two-stage seton procedure for anal fistula (16 extrasphincteric and 18 trans-sphincteric) with a high anal or rectal internal opening. Thirty-one patients had normal preoperative continence. There were two recurrences. All trans-sphincteric fistulas healed. Twenty-nine patients with preoperative normal faecal control were available for follow-up. Postoperative continence was normal in 12 patients (category A according to Browning and Parks classification2); five patients had no control over flatus (B), 11 were incontinent for liquid stool or flatus (C) and one had continued faecal leakage (D). The two-stage seton technique is not recommended for fistulas with high anal or rectal openings.
authors.affiliation: Department of Surgery, University Hospital Nijmegen, Netherlands.
authors.forename: W F
authors.initials: WF
authors.lastname: Van Tets
authors.forename: J H
authors.initials: JH
authors.lastname: Kuijpers
mesh_terms: D000328:Adult; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012003:Rectal Fistula / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome