The Seton Technique in Perianal Fistula Surgery: Clinical Outcomes of Two Different Types of Seton Material

Abstract

Aim: In this study we aimed to compare the recurrence, incontinence and treatment success rates in patients with perianal fistulas (PF) who were operated on using two different seton materials.Methods: We retrospectively reviewed the medical records (PF characteristics, length of hospital stay and follow-up, postoperative complications, and presence of recurrence and incontinence) of a total of 66 patients who were diagnosed with PF and operated on using the seton method in a medical faculty hospital between January 2016 and May 2020. The patients were divided into two groups according to the seton material used (Prolene or elastic band material obtained from surgical gloves). Incontinence assessments were made using the Jorge–Wexner incontinence scoring system.Results: Of the patients, 48 (72.7%) were male and 18 (27.3%) were female. Prolene and elastic seton materials were used in the surgery of 26 (39.4%) and 40 (60.6%) patients, respectively. The general recovery rate was 93.9%, recurrence rate was 7.6%, and incontinence rate was 6.1%. Although the recurrence and incontinence rates were higher in the Prolene group, there was no statistically significant difference between the two groups (p=0.074 and p=0.292, respectively).Conclusion: Elastic material obtained from surgical gloves can be used as a seton in PF surgery, with low rates of recurrence and acceptable rates of incontinence similar to those with traditional cutting seton materials.