Role of seton versus conventional techniques in the management of anorectal fistulas

Authors

  • Mohammad Sadik Akhtar Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India
  • Sheikh Saif Alim Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India
  • Mohammad Habib Raza Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India
  • Wasif Mohammad Ali Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202828

Keywords:

Anorectal fistulas, Fistulectomy, Fistulotomy, Perianal abscess, Setons

Abstract

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.

 

Author Biographies

Mohammad Sadik Akhtar, Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India

ASSISTANT PROFESSOR,
DEPARTMENT OF SURGERY,
JAWAHARLAL NEHRU MEDICAL COLLEGE,
ALIGARH MUSLIM UNIVERSITY,
ALIGARH

Sheikh Saif Alim, Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India

JUNIOR RESIDENT (3RD YEAR)
DEPARTMENT OF SURGERY
JAWAHARLAL NEHRU MEDICAL COLLEGE
ALIGARH MUSLIM UNIVERSITY
ALIGARH

Mohammad Habib Raza, Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India

ASSISTANT PROFESSOR,
DEPARTMENT OF SURGERY,
JAWAHARLAL NEHRU MEDICAL COLLEGE,
ALIGARH MUSLIM UNIVERSITY,
ALIGARH

Wasif Mohammad Ali, Department of Surgery, JNMCH, AMU, Aligarh, Uttar Pradesh, India

ASSISTANT PROFESSOR,
DEPARTMENT OF SURGERY,
JAWAHARLAL NEHRU MEDICAL COLLEGE,
ALIGARH MUSLIM UNIVERSITY,
ALIGARH

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Published

2020-06-25

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Original Research Articles