Loose Seton Technique as a Conventional Procedure for the Treatment of Anal Fistula and Long-Term Results

Abstract

Aim: The seton technique has long been used with success for the treatment of anal fistulas. This technique is recommended in the literature as a method which decreases anal incontinence in fistula surgery. This study aims to retrospectively analyze the long-term outcomes of anal patients on whom we performed loose seton technique for fistula surgery. Patients and Methods: The information of 50 patients with the diagnosis of anorectal fistula on whom loose seton technique was performed at our clinic between November 2014 and June 2016 were retrospectively reviewed by using the individual follow-up forms of each patient. Results: Fifty patients were included in the study. The mean follow-up time was 21 months. The etiology was crypto glandular abscess in 20 patients, Crohn's disease in 2 patients and idiopathic in 28 patients. In 23 patients without spontaneous resolution of fistula and incomplete division of internal sphincter muscle fibers underwent controlled fistulotomy. Spontaneous resolution of fistula tract had occurred in the remaining 27 patients. In all patients included in the study, complete healing was achieved and no recurrence, no total incontinans occurred during the 21-month mean follow-up period. Conclusion: New treatment modalities have emerged for anal fistulas in recent years. Many studies were performed comparing these modalities to the conventional methods and none of these studies showed superiority over the conventional methods. The loose seton procedure is a well-tolerated modality for the treatment of anal fistula with low recurrence and incontinence rates during a long follow-up period of 21 months.