Short-term drainage seton versus two-stage seton fistulotomy in the surgical management of high anal fistula

ABSTRACT

In the present study, the clinical results obtained by both seton techniques in the surgical management of high anal fistula are compared. The study included 31 patients with high anal fistulae treated surgically by either short-term drainage seton [STDS] [n = 12] or two-stage seton fistulotomy [TSSF] [n = 19]. Complete primary healing occurred in nine patients who underwent STDS and 17 of the patients who underwent TSSF. Two of the three patients treated by STDS in whom the fistula persisted or recurred were treated successfully with subsequent division of the external sphincter and healing occurred to these patients. Following surgery using STDS, partial incontinence occurred in two patients only who reported problems controlling flatus. In conclusion, the present study confirmed that STDS can be utilizing with success and allowing preservation of the sphincter muscle and it can be used as the initial procedure for the high and difficult anal fistulae