The use of a staged drainage seton for the treatment of anal fistulae or fistulous abscesses.
OBJECTIVE
The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.


METHODS
According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.


RESULTS
The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.


CONCLUSIONS
In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.
Department of Coloproctology, Yang Hospital, Seoul, Korea.
Cheong Ho
CH
Lim
Hyeon Keun
HK
Shin
Wook Ho
WH
Kang
Chan Ho
CH
Park
Sa Min
SM
Hong
Seung Kyu
SK
Jeong
June Young
JY
Kim
Hyung Kyu
HK
Yang
Fistula; Perianal abscess; Seton; Surgical drainage