THE EFFICACY OF CUTTING SETON IN TREATMENT OF HIGH ANAL FISTULA

*Dr. Saad Y. Ibrahim

ABSTRACT

Background: Fistula in- ano is a common conditions that facing thousands of patients. Different surgical methods are used for treatment of high anal fistula. The best surgical option of treatment is variable because they carry different rate of cure and incontinence. Objective: is to evaluate the efficacy and safety of seton in treatment of high anal fistula. Methods: a prospective study of 38 patients (36 males and 2 females) with high anal fistula above the dentate line which involve more than 30% internal sphincter treated with cutting seton from April 2013 to June 2016. The seton tightened every 2 weeks under general anesthesia for 2 times and removed after 6 weeks. Follow up after 1, 3, 6 months respectively for incontinence and recurrence. Results: from all 38 patients there were no postoperative flatus and liquid stool incontinence. No fecal incontinence in any patient. There was only one fistula recurrence with cutting seton with healing rate 100%. Conclusion: The use of Cutting seton in treatment of high fistula in ano is an effective and relatively safe with no rate of incontinence. Therefore it can be recommended as an option for treatment of high fistula-in-ano.

Keywords: High anal fistula, seton.