RESUMO
Background: This study was conducted to compare the use of different setons with conventional management like fistulotomy and fistulectomy in terms of healing (after 1 and 3 months), recurrence and incontinence.Methods: This was a retrospective non-randomized study conducted at JNMCH, Aligarh from January 2018 to June 2019. Patients included- patients (males and females) of age group 18-70 years, patients giving consent. Patients excluded- fistula secondary to- Crohn’s disease, tuberculosis, malignancy, recurrent fistula, pregnant females, immuno-suppressed patients.Results: After 1 month, 17 out of 24 patients (70.8%) of fistulotomy, 48 out of 68 patients (70.6%) of seton group and 21 out of 32 patients (65.6%) of fistulectomy group had their wounds healed (p=0.8693). After 3 months, 19 out of 24 (79.2%) patients of fistulotomy, 61 out of 68 (89.7%) of seton, and 24 out of 32 patients (75%) with fistulectomy had their wound healed (p=0.1374). Recurrence was observed in 5 out of 24 patients of fistulotomy, 10 out of 68 patients of seton use and 5 out of 32 patients with fistulectomy (p=0.7788). 6 out of 24 patients (25%) had incontinence after fistulotomy, 7 out of 68 (10.3%) of seton group and 8 out of 24 (25%) after fistulectomy (p=0.0944). Healing was higher in patients of non-cutting setons as compared to cutting seton (p=0.0252). After 3 months, no difference was observed (p=0.1245). Recurrence higher in cutting setons as compared to non-cutting setons (p=0.0187).Conclusions: Setons are safe, low-cost, less invasive, precise, and cost-effective option for treating simple and complex fistula-in-ano.
RESUMO
The goal of this pictorial review is the evaluation of perianal fistulas by means of magnetic resonance imaging. This technique has been shown to demonstrate accurately the anatomy of the perianal region. Our MRI protocol is simple and easy to standardize. We use the classification of St James University Hospital which employs simple anatomic discriminators identifiable on axial and coronal planes. Several examples are shown with emphasis in the importance of this classification.
El objetivo de esta revisión pictográfica es la evaluación de las fístulas anorrectales mediante resonancia magnética. Esta técnica ha demostrado ser altamente confiable para estudiar la anatomía de la región perianal. Nuestro protocolo de estudio es simple y fácil de estandarizar. Usamos la clasificación del Hospital de la Universidad de Saint James (Inglaterra) que enfatiza la relación de la fístula con el esfínter externo y su importancia en la continencia anal.