Annals of Coloproctology

Display

Sort by :

Original Articles

Evaluation of a Seton Procedure Combined With Infliximab Therapy (Early vs. Late) in Perianal Fistula With Crohn Disease: Myunghoon Jeon, Kihwan Song, Jail Koo, Sohyun Kim; Ann Coloproctol. 2019;35(5):249-253. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.11.23.1

5,215 View
129 Download
12 Web of Science
12 Citations

Purpose
We assessed the clinical outcomes of a seton procedure combined with early versus late institution of infliximab (IFX) therapy.
Methods
This retrospective study comprised 76 patients who underwent surgery for perianal fistula associated with Crohn disease between January 2014 and November 2017. All patients underwent loose seton drainage combined with IFX therapy. Patients categorized as the early group (EG, 49 patients) received IFX therapy within 30 days of completion of the seton procedure. Patients categorized as the late group (LG, 27 patients) received IFX therapy >30 days after the seton procedure. IFX therapy was administered as induction and maintenance therapy.
Results
There were no statistically significant intergroup differences in clinical characteristics of the patients. The mean follow-up was 21.0 ± 11.6 months in the EG and 34.5 ± 18.4 months in the LG (P = 0.001). The mean interval between seton procedure and IFX induction therapy was 12.2 days in the EG and 250.2 days in the LG (P = 0.002). Complete remission was observed in 32 patients (65.3%) in the EG and 17 patients (63.0%) in the LG (P = 0.844). Fistula recurrence was observed in 6 patients (7.9%). All recurrences occurred in a previous perianal fistula tract.
Conclusion
Patients showed a good response to a seton procedure combined with IFX therapy regardless of the time of initiation of IFX therapy.

Citations

Citations to this article as recorded by

Management of Anal Fistula with Crohn's Disease
Shota Takano, Yasushi Nakamura, Kohei Tamaoka, Takafumi Yoshimoto, Yasue Irei, Yoriyuki Tsuji
Journal of the Anus, Rectum and Colon.2025; 9(1): 10. CrossRef
Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
Inflammatory Bowel Diseases.2024; 30(9): 1579. CrossRef
The use of core descriptors from the ENiGMA code study in recent literature: a systematic review
Saher‐Zahra Khan, Andrea Arline, Kate M. Williams, Matthew J. Lee, Emily Steinhagen, Sharon L. Stein
Colorectal Disease.2024; 26(3): 428. CrossRef
Impact of Seton Use on Clinical, Patient-Reported, and Healthcare Resource Utilization Outcomes in Complex Crohn’s Perianal Fistulas: A Systematic Literature Review
Ian White, Chitra Karki, Parnia Geransar, Lilia Leisle, Sophia Junker, Phillip Fleshner
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
The Optimal Management of Fistulizing Crohn’s Disease: Evidence beyond Randomized Clinical Trials
Panu Wetwittayakhlang, Alex Al Khoury, Gustavo Drügg Hahn, Peter Laszlo Lakatos
Journal of Clinical Medicine.2022; 11(11): 3045. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula
Wolfgang B. Gaertner, Pamela L. Burgess, Jennifer S. Davids, Amy L. Lightner, Benjamin D. Shogan, Mark Y. Sun, Scott R. Steele, Ian M. Paquette, Daniel L. Feingold
Diseases of the Colon & Rectum.2022; 65(8): 964. CrossRef
Management of perianal fistula in inflammatory bowel disease: identification of prognostic factors associated with surgery
Sara Gortázar de Las Casas, Mario Alvarez-Gallego, Jose Antonio Gazo Martínez, Natalia González Alcolea, Cristina Barragán Serrano, Aitor Urbieta Jiménez, María Dolores Martín Arranz, Jose Luis Marijuan Martín, Isabel Pascual Migueláñez
Langenbeck's Archives of Surgery.2021; 406(4): 1181. CrossRef
Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon’s Point of View
Jong Lyul Lee, Yong Sik Yoon, Chang Sik Yu
Annals of Coloproctology.2021; 37(1): 5. CrossRef
Multidisciplinary management of perianal Crohn's disease
Suha Abushamma, David H. Ballard, Radhika K. Smith, Parakkal Deepak
Current Opinion in Gastroenterology.2021; 37(4): 295. CrossRef
Approach to medical therapy in perianal Crohn’s disease
Abhinav Vasudevan, David H Bruining, Edward V Loftus, William Faubion, Eric C Ehman, Laura Raffals
World Journal of Gastroenterology.2021; 27(25): 3693. CrossRef
Infliximab

Reactions Weekly.2020; 1785(1): 284. CrossRef
Mesenchymal stem cells in perianal Crohn’s disease
H. Guadalajara, M. García-Arranz, M. Dolores Herreros, K. Borycka-Kiciak, A. L. Lightner, D. García-Olmo
Techniques in Coloproctology.2020; 24(8): 883. CrossRef

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients: Bader Hamza Shirah, Hamza Asaad Shirah; Ann Coloproctol. 2018;34(5):234-240. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2018.03.23

11,558 View
171 Download
17 Web of Science
15 Citations

Abstract PDF

Purpose
A cutting seton is used after a partial distal fistulotomy to treat patients with a high exrasphincteric fistula in ano to avoid fecal incontinence and recurrence. In Saudi Arabia, religious practices necessitate complete cleanness, which makes conditions affecting anal continence a major concern to patients affected by an anal fistula. Therefore, we aimed to evaluate the efficiency of the cutting seton in treating a high anal fistula among Saudi Arabians.
Methods
Between January 2005 and December 2014, a prospective study was done for 372 Saudi Arabian patients diagnosed as having a high anal fistula and treated with a cutting seton at Al-Ansar General Hospital, Medina, Saudi Arabia. 0-silk sutures were used. All patients underwent the same preoperative assessment, operative technique, and postoperative follow-up. Weekly, the seton was tightened in outpatient clinics.
Results
Two hundred ninety-eight patients (80.1%) were males and 74 (19.9%) females. The duration of symptoms varied from 3–21 months. The fistula healed completely in 363 patients (97.6%); 58 patients (15.6%) reported some degree of incontinence to flatus, but none to feces. In 9 patients (2.4%) the fistula recurred.
Conclusion
The utilization of the cutting seton method in the treatment of patients with a high anal fistula is highly efficient as it simultaneously drains the abscess, cuts the fistulous tract, and causes fibrosis along the tract. Treatment of a high anal fistula by using a staged fistulotomy with a cutting seton was very rewarding to Saudi Arabian patients who feared anal incontinence for religious reasons and was associated with low postoperative complication and recurrence rates.

Citations

Citations to this article as recorded by

Ultrasound assessment of low type intersphincteric perianal fistulas in Yemen
Sultan Abdulwadoud Alshoabi, Abdulkhaleq Ayedh Binnuhaid, Abdullgabbar M. Hamid, Fahad H. Alhazmi, Abdulaziz A. Qurashi, Awadia Gareeballah, Moawia Gameraddin, Osamah M. Abdulaal, Walaa Alsharif, Fathelrehman A. Elajab, Tareef S. Daqqaq, Khaled Mohammed A
Scientific Reports.2025;[Epub] CrossRef
Cutting seton for the treatment of cryptoglandular fistula-in-ano: a systematic review and meta-analysis
J. Khamar, A. Sachdeva, T. McKechnie, Y. Lee, L. Tessier, D. Hong, C. Eskicioglu
Techniques in Coloproctology.2024;[Epub] CrossRef
Evaluation surgical strategies in perianal fistulas treatment: Efficacy draining seton compared to other surgical approaches; a case‐control study
Amir Ghasemlouei, Amirhosein Naseri, Ali Ashjaei, Shahryar Sadeghi, Amir Keshvari
Health Science Reports.2024;[Epub] CrossRef
Assessing the suitability of video-assisted anal fistula treatment for obese patients compared to conventional surgery: a question worth investigating
Xiao-Li Tang, Zi-Yang Xu, Jun Yang, Zhe Yang, Zhi-Gang Wang, Zheng-Yun Zhang, Jing Yao
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial
Jiawei Qin, Yanlan Wu, Xueping Zheng, Kunlan Wu, Gongjian Dai, Yanyan Tan, Xu Yang, Yuqing Sun
Journal of the American College of Surgeons.2024; 239(6): 563. CrossRef
Fistulectomy and primary sphincteroplasty in complex anal fistula treatment: a hospital-based long-term follow-up study
Fakhrosadat Anaraki, Mohammad Reza Nikshoar, Arsh Haj Mohamad Ebrahim Ketabforoush, Rojin Chegini, Nasrin Borumandnia, Mehdi Tavallaei
Techniques in Coloproctology.2023; 27(2): 145. CrossRef
Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
Life.2023; 13(10): 2008. CrossRef
Surgical treatment of anal fistula
A. Ya. Ilkanich, V. V. Darwin, E. A. Krasnov, F. Sh. Aliyev, K. Z. Zubailov
Сибирский научный медицинский журнал.2023; 43(5): 74. CrossRef
Evaluation of the Cutting Seton Technique in Treating High Anal Fistula
Asim M Almughamsi, Mohamed Khaled S Zaky, Abdullatif M Alshanqiti, Ibrahim S Alsaedi, Hamed I Hamed, Tariq E Alharbi, Ali A Elian
Cureus.2023;[Epub] CrossRef
Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub] CrossRef
Evaluating the Efficacy of Cutting Setons for the Treatment of Anal Fistulas
Miguel E. Gomez, Koianka Trencheva, Matthew Symer, Kelly Garrett, Jeffrey W. Milsom, Parul J. Shukla
Indian Journal of Surgery.2022; 84(5): 961. CrossRef
Advancing standard techniques for treatment of perianal fistula; when tissue engineering meets seton
Hojjatollah Nazari, Zahra Ebrahim Soltani, Reza Akbari Asbagh, Amirsina Sharifi, Abolfazl Badripour, Asieh Heirani Tabasi, Majid Ebrahimi Warkiani, Mohammad Reza Keramati, Behnam Behboodi, Mohammad Sadegh Fazeli, Amir Keshvari, Mojgan Rahimi, Seyed Mohsen
Health Sciences Review.2022; 3: 100026. CrossRef
Treatment of the fistula tract with laser ablation in high anal fistula
Erkan Karacan, Eyüp Murat Yılmaz
Journal of Clinical Medicine of Kazakhstan.2022; 19(6): 43. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
Journal of Coloproctology.2020; 40(01): 056. CrossRef
A Commentary on the article: “Risk factors for recurrence after anal fistula surgery: A meta-analysis”, Int J Surg 2019;69:153–164
F. Karimian
International Journal of Surgery.2019; 71: 79. CrossRef

Application of Advancement Flap After Loose Seton Placement: A Modified Two-Stage Surgical Repair of a Transsphincteric Anal Fistula: Metin Ertem, Hakan Gok, Emel Ozveri, Volkan Ozben; Ann Coloproctol. 2014;30(4):192-196. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.192

11,822 View
73 Download
7 Web of Science
11 Citations

Abstract PDF

Purpose

A number of techniques have been described for the treatment of a transsphincteric anal fistula. In this report, we aimed to introduce a relatively new two-stage technique, application of advancement flap after loose seton placement, to present its technical aspects and to document our results.

Methods

Included in this retrospective study were 13 patients (10 males, 3 females) with a mean age of 42 years who underwent a two-stage seton and advancement flap surgery for transsphincteric anal fistula between June 2008 and June 2013. In the first stage, a loose seton was placed in the fistula tract, and in the second stage, which was performed three months later, the internal and external orifices were closed with advancement flaps.

Results

All the patients were discharged on the first postoperative day. The mean follow-up period was 34 months. Only one patient reported anal rigidity and intermittent pain, which was eventually resolved with conservative measures. The mean postoperative Wexner incontinence score was 1. No recurrence or complications were observed, and no further surgical intervention was required during follow-up.

Conclusion

The two-stage seton and advancement flap technique is very efficient and seems to be a good alternative for the treatment of a transsphincteric anal fistula.

Citations

Citations to this article as recorded by

Loss of seton in patients with complex anal fistula: a retrospective comparison of conventional knotted loose seton and knot-free seton
C. Verkade, D. D. E. Zimmerman, D. K. Wasowicz, S. W. Polle, H. S. de Vries
Techniques in Coloproctology.2020; 24(10): 1043. CrossRef
Relocation and silastic tension only (RASTO) procedure for very long anal fistula tracts: Initial case series with results of a new surgical technique
John Alfred Carr
International Journal of Surgery Open.2020; 26: 1. CrossRef
Anal fistula plug vs rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta‐analysis of studies with long‐term follow‐up
H. Lin, Z. Jin, Y. Zhu, M. Diao, W. Hu
Colorectal Disease.2019; 21(5): 502. CrossRef
A comparative study on the effectiveness of rectal advancement flap and seton placement surgeries in patients with anal fistula on the rate of recurrence, incontinence and infection
Jafar Jafarzadeh, Neda Najibpoor, Amirahmad Salmasi
Journal of Family Medicine and Primary Care.2019; 8(11): 3591. CrossRef
Análisis y descripción de la calidad de vida específica en pacientes con fístula anal
Manuel Ferrer-Márquez, Natalia Espínola-Cortés, Ángel Reina-Duarte, José Granero-Molina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla
Cirugía Española.2018; 96(4): 213. CrossRef
Analysis and Description of Disease-Specific Quality of Life in Patients With Anal Fistula
Manuel Ferrer-Márquez, Natalia Espínola-Cortés, Ángel Reina-Duarte, José Granero-Molina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla
Cirugía Española (English Edition).2018; 96(4): 213. CrossRef
Seton drainage in sphincter-sparing treatment of rectal fistulas
A. I. Musin, I. V. Kostarev
Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (8): 65. CrossRef
Adoption and success rates of perineal procedures for fistula‐in‐ano: a systematic review
C. Kontovounisios, P. Tekkis, E. Tan, S. Rasheed, A. Darzi, S. D. Wexner
Colorectal Disease.2016; 18(5): 441. CrossRef
Evaluation of the inflammatory response induced by different materials in the treatment of perianal fistulas: experimental study in rats
Mariana Ocampos Galvão, Carlos Henrique Marques dos Santos, Gustavo Ribeiro Falcão
Journal of Coloproctology.2016; 36(01): 016. CrossRef
TREATMENT OF FISTULA IN ANO BY ADVANCEMENT FLAP. IS IT OUTDATED OR STILL MODERN APPROACH?
I. V. Kostarev, Y. A. Shelygin, A. Y. Titov
Koloproktologia.2016; (1): 6. CrossRef
Advancement Flap for the Treatment of a Complex Anal Fistula
Do Sun Kim
Annals of Coloproctology.2014; 30(4): 161. CrossRef

The Use of a Staged Drainage Seton for the Treatment of Anal Fistulae or Fistulous Abscesses: Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Chan Ho Park, Sa Min Hong, Seung Kyu Jeong, June Young Kim, Hyung Kyu Yang; J Korean Soc Coloproctol. 2012;28(6):309-314. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.309

7,485 View
68 Download
28 Citations

Abstract PDF

Purpose

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.

Conclusion

In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.

Citations

Citations to this article as recorded by

Efficacy and safety of video-assisted anal fistula treatment in anorectal fistula: a meta-analysis
Chunqiang WANG, Tianye HUANG, Xuebing WANG
Minerva Gastroenterology.2024;[Epub] CrossRef
Loose seton in the treatment of transsphincteric anal fistulas complicated by additional fistula tracks (randomized trial)
A. G. Khitaryan, A. Z. Alibekov, A. A. Golovina, S. A. Adizov, X. S. Oplimakh
Koloproktologia.2024; 23(4): 94. CrossRef
A Large Study on Lifestyle Factors Increasing Probability of Fistula and Factors Responsible for Recurrent Fistula
Hitender Suri, Deepika Suri, Kamalpreet Bansal, Sauvik Suri, Virendera Ghodke
International Journal of Medical and Oral Research.2022; 7(1): 4. CrossRef
Fistula in Ano: Evolution of Treatment and Present Scenario
Nisar A. Chowdri
Indian Journal of Colo-Rectal Surgery.2022; 5(3): 37. CrossRef
Ambulatory seton placement followed by fistulotomy: efficacy and safety for perianal fistula treatment
Verónica Gamelas, Guilherme Simões, Sara Santos, Rafaela Loureiro, Isabel Seves, João Costa Simões, Maria João Bettencourt
European Journal of Gastroenterology & Hepatology.2021; 33(7): 956. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
Journal of Coloproctology.2020; 40(01): 056. CrossRef
How to deal with complex anal fistula in an immunosuppressed patient
Marie S. De Robles, Robert D. R. Winn
ANZ Journal of Surgery.2020; 90(9): 1764. CrossRef
Relocation and silastic tension only (RASTO) procedure for very long anal fistula tracts: Initial case series with results of a new surgical technique
John Alfred Carr
International Journal of Surgery Open.2020; 26: 1. CrossRef
Comparison of the Efficacy of the Various Treatment Modalities in the Management of Perianal Crohn’s Fistula: A Review
Shah Huzaifa Feroz, Asma Ahmed, Abilash Muralidharan, Pragatheeshwar Thirunavukarasu
Cureus.2020;[Epub] CrossRef
Nigam′s Modified Roeder′s Knot in Cutting Seton in High Fistula-in-ano Prevents Rethreading and Reapplication of Seton
VK Nigam, Siddharth Nigam
World Journal of Colorectal Surgery.2020; 9(4): 64. CrossRef
Loose Seton Technique as a Conventional Procedure for the Treatment of Anal Fistula and Long-Term Results
Hasan Calis
Acta Medica Alanya.2019; 3(1): 67. CrossRef
Ligature method for the treatment of anal fistula: a modern view on the old approach (literature review)
A. I. Musin, E. V. Antipova, A. A. Ulyanov, D. E. Kuznetsov
Grekov's Bulletin of Surgery.2019; 178(2): 79. CrossRef
Drainage Seton Versus External Anal Sphincter–Sparing Seton After Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial
Waleed Omar, Abdallah Alqasaby, Mahmoud Abdelnaby, Mohamed Youssef, Mostafa Shalaby, Mohamed Anwar Abdel-Razik, Sameh Hany Emile
Diseases of the Colon & Rectum.2019; 62(8): 980. CrossRef
What every PA needs to know about anorectal pain
Yasmine Hubbard, Denise Rizzolo
JAAPA.2019; 32(1): 1. CrossRef
Draining Setons as Definitive Management of Fistula-in-Ano
Oluwatomilayo O. Daodu, Julia O’Keefe, John A. Heine
Diseases of the Colon & Rectum.2018; 61(4): 499. CrossRef
Gender-based analysis of the characteristics and outcomes of surgery for anal fistula: analysis of more than 560 cases
Sameh Hany Emile, Hesham Elgendy, Ahmad Sakr, Mohamed Youssef, Waleed Thabet, Waleed Omar, Wael Khafagy, Mohamed Farid
Journal of Coloproctology.2018; 38(03): 199. CrossRef
The treatment of anal fistula: secondACPGBIPosition Statement – 2018
G. Williams, A. Williams, P. Tozer, R. Phillips, A. Ahmad, D. Jayne, C. Maxwell‐Armstrong
Colorectal Disease.2018; 20(S3): 5. CrossRef
Seton drainage in sphincter-sparing treatment of rectal fistulas
A. I. Musin, I. V. Kostarev
Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (8): 65. CrossRef
High ligation of the anal fistula tract by lateral approach: A prospective cohort study on a modification of the ligation of the intersphincteric fistula tract (LIFT) technique
Wook Ho Kang, Hyung Kyu Yang, Han Jeong Chang, Yong Taek Ko, Byung Eun Yoo, Cheong Ho Lim, Jae Kwan Hwang, Young Chan Lee, Hyeon Keun Shin, Hae Jung Son
International Journal of Surgery.2018; 60: 9. CrossRef
Anal Fistula Laser Closure: the length of fistula is the Achilles’ heel
A. Lauretta, N. Falco, E. Stocco, R. Bellomo, A. Infantino
Techniques in Coloproctology.2018; 22(12): 933. CrossRef
Video-Assisted Anal Fistula Treatment (VAAFT) for Complex Anal Fistula: A Preliminary Evaluation in China
Hui-hong Jiang, Hai-long Liu, Zhen Li, Yi-hua Xiao, A-jian Li, Yi Chang, Yong Zhang, Liang Lv, Mou-bin Lin
Medical Science Monitor.2017; 23: 2065. CrossRef
Predictive factors for recurrence of high transsphincteric anal fistula after placement of seton
Sameh Hany Emile, Hossam Elfeki, Waleed Thabet, Ahmed Sakr, Alaa Magdy, Tito M Abd El-Hamed, Waleed Omar, Wael Khafagy
Journal of Surgical Research.2017; 213: 261. CrossRef
Retrospective analysis of patients submitted to surgical treatment of perianal fistula in Santa Marcelina Hospital, São Paulo
Isaac José Felippe Corrêa Neto, Janaína Wercka, Diego Palmeira Rangel, Eduardo Augusto Lopes, Hugo Henriques Watté, Rogério Freitas Lino Souza, Alexander Sá Rolim, Laercio Robles
Journal of Coloproctology.2017; 37(03): 193. CrossRef
Evaluation of the cutting seton as a method of treatment for perianal fistula
Salah M. Raslan, Mohammed Aladwani, Nasser Alsanea
Annals of Saudi Medicine.2016; 36(3): 210. CrossRef
Adapting fistula surgery to fistula tract and patient condition: towards a tailored treatment
I. Pascual Miguelañez, M. Alvarez Gallego, I. Rubio Perez, T. Funes Dueñas, J. A. Gazo Martinez
European Surgery.2016; 48(1): 4. CrossRef
Evaluation of the inflammatory response induced by different materials in the treatment of perianal fistulas: experimental study in rats
Mariana Ocampos Galvão, Carlos Henrique Marques dos Santos, Gustavo Ribeiro Falcão
Journal of Coloproctology.2016; 36(01): 016. CrossRef
The role of loose seton in the management of anal fistula: a multicenter study of 200 patients
M. E. Kelly, H. M. Heneghan, F. D. McDermott, G. J. Nason, C. Freeman, S. T. Martin, D. C. Winter
Techniques in Coloproctology.2014; 18(10): 915. CrossRef
Management of Fistula-in-Ano—The Current Evidence
Parvez Sheikh, Atef Baakza
Indian Journal of Surgery.2014; 76(6): 482. CrossRef

Review

Surgery in an Intersphincteric Fistula.: Lim, Seok Won; J Korean Soc Coloproctol. 2009;25(6):365-371.; DOI: https://doi.org/10.3393/jksc.2009.25.6.365

2,801 View
35 Download
1 Citations

Abstract PDF

An intersphincteric fistula is the most common type of fistula, about 70% of all fistulas, and is often encountered by the surgeon during anal surgery. The operative procedures include a simple fistulotomy, a fistulectomy, a cutting seton technique, and a sphincter-saving technique. Most posterior-located intersphincteric fistulas can be successfully treated by using the lay-open technique, but using that technique in cases of lateral- or anterior-located fistulas may result in incontinence or anal deformity. In this respect, a sphincter-saving technique has more advantage in sparing anal function than other procedures in cases of lateral or anterior fistulas, but the recurrence rate is high. The delayed open method with seton techniques have a low recurrence rate, but do not preserve anal function well. As mentioned above, the operative method for treating intersphincteric fistulas should be suitable for keeping sphincter tone and should have a low recurrence rate. This article discusses the rationale for and the estimated effectiveness of many operative methods for treating intersphincteric fistulas.

Citations

Citations to this article as recorded by

New Techniques for Treating an Anal Fistula
Kee Ho Song
Journal of the Korean Society of Coloproctology.2012; 28(1): 7. CrossRef

Original Articles

Self-pulsed Washable Seton during a Modified Hanley Operation for a Deep Horseshoe Fistula.: Choi, Donghwi , Seo, Hyung Il , Kim, Hyunsung , Oh, Nahmgun; J Korean Soc Coloproctol. 2008;24(4):246-251.; DOI: https://doi.org/10.3393/jksc.2008.24.4.246

1,906 View
20 Download
1 Citations

Abstract PDF

PURPOSE
The modified Hanley technique, which is used for treatment of a deep horseshoe fistula, has reduced damage to the external anal sphincter compared to the classic Hanley technique, but its shortcoming is that it causes inconvenience to the patient due to the fact that a drainage tube must be left in place for a long time. To solve this problem, the authors devised a self-pulsed washable seton and then compared the results of its use to determine its clinical usefulness.
METHODS
The subjects of this study were 34 patients who were diagnosed with a deep posterior complex anal fistula and who were operated on by using the modified Hanley technique between January 1999 and December 2004. Twelve patients who were treated with the self-pulsed washable seton were classified as Group A, and 12 patients who were treated by using a conventional loose seton were placed in Group B. These two groups were compared for period of purulent discharge, period of leaving the seton alone, and recurrence rate.
RESULTS
The period of purulent discharge was 18.75 days (15~24) for group Aand 29.75 days (24~37) for group B. The period of leaving the seton was 21.58 days (18~29) for group A and 32.58 days (28~39) for group B. The recurrence rate after surgery was 8.3% in group A and 16.7% in group B.
CONCLUSIONS
The self-pulsed washable seton devised by the authors shortened the treatment period through more effective wound management, so we propose using it as a new method for treating a deep posterior horseshoe fistula.

Citations

Citations to this article as recorded by

Patient-Performed Seton Irrigation for the Treatment of Deep Horseshoe Fistula
Donghwi Choi, Hyun Sung Kim, Hyung-Il Seo, Nahmgun Oh
Diseases of the Colon & Rectum.2010; 53(5): 812. CrossRef

The Clinical Effect of Sphincter-Preserving Modified Loose Seton Technique in Complex Anal Fistula.: Lee, Yun Young , Choi, Sun Keun , Kim, Sei Joong , Lee, Keon Young , Hur, Yoon Seok , Ahn, Seung Ik , Hong, Kee Chun , Shin, Seok Hwan , Woo, Ze Hong; J Korean Soc Coloproctol. 2002;18(3):156-162.

1,404 View
26 Download

Abstract PDF: PURPOSE
The cutting seton technique is a world-wide operative method in management of a complex anal fistula. However it has still some risks of anal deformity and fecal incontinence because of sphincter injury, and also required two-stage operation under the anesthesia. We have modified this conventional method into sphincter-preserving technique using the seton and evaluated the clinical effect of patients with complex anal fistula.
METHODS
The operative steps consisted of excision of the fistular tract without cutting the sphincter, and insertion of a non-absorbable suture material as a seton around the sphincter. When enough fibro-granulated tissues grew and pus discharge decreased markedly, the seton was just cut out from the wound without anesthesia at the outpatient basis. The clinical effect following treatment by using this method was assessed retrospectively in 81 patients, including 33 recurrent cases, who were treated during the four and a half-year period.
RESULTS
The average follow-up period to remove the seton and to eradicate the fistula was 68.9+/-39.5 and 82.1+/-45.6 days, respectively. No patients experienced fecal incontinence after surgery. The fistula was healed without recurrence in 78 patients (96.3%), preserving integrity of the sphincter. Recurrence developed in 3 patients who had two suprasphincteric fistulas and one transsphincteric fistula with supralevator abscess.
CONCLUSION
We suggest that this method is good for treating complex anal fistulas without two-stage operation because it has some advantages such as a lower recurrence, a lower functional impairment, and less anal deformity.

Treatment of Fistula in ano by Kshara Sutra.: Choi, Kyung Dal; J Korean Soc Coloproctol. 2000;16(1):25-28.

2,106 View
34 Download

Abstract PDF: PURPOSE
Sushrutra (BC 5th century) advocated a conservative management by applying Kshara Sutra (phyto-chemically processed thread) for the treatment of anal fistulas in India. In 1965, this technique was introduced by Deshpande and 40 cases were treated on an "outpatient" ambulatory basis. The purpose of this study is to determine the result of Kshara Sutra (KS) in treatment of fistula in ano.
METHODS
One hundred and five patients with anal fistula were treated with KS. Excision of the primary lesion and fistula tract was done externally and KS was passed around the tract. Tissue gripped within the thread was the anoderm, mucosa, and sphincter. Finally, the thread encircled the part of the anal wall that needed excision and an additional clamp for loose tying.
RESULTS
The range of age was from 21 to 59 years while the sex ratio was 6.5:1 (M:F). In 94 patients, the average cutting time was about two weeks, and the other were three to four weeks. KS thread was applied only once for primary operation in 98 cases, and a successive change was required in 7 cases. The mean hospital stay after operation was 4.2 days. In 76 cases, the mean period of follow up was 23 (range 7~32) months. There were no recurrences, but there were 4 mild deformities of the anus, 2 mild soilings, 1 delayed cutting, and 5 delayed healings.
CONCLUSIONS
Kshara Sutra is a technically easy, safe, and simple method and does not require a long hospitalization.

First
Prev
Page of 1
Next
Last

Search