Outcome of Draining setons in the management of complex transsphincteric fistula and recurrence rates
Abstract
Objectives: The purpose of the study was to determine the role of draining seton in management of patients with fistula-in-ano with respect to duration of hospital stay and recurrences.
Method: This hospital based prospective observational study included patients with trans-sphincteric fistula where complete debridement was possible with minimum of 3 month follow up after removal of seton . Loose seton was inserted at time of surgery after excision of tract with regular follow up after surgery and post seton removal to know about recurrences.
Results: Twenty six patients were included in study and all of them presented with chief complaint of perianal discharge followed by perianal itching and pain. Duration of symptoms ranged from 4 to 48 months .Twenty two out of 26 cases had undergone surgical procedures in past , with a total of 40 surgical procedures and mean of 1.81 surgical procedures in each patient . Postoperative hospital stay ranged from 1 to 6 days with mean hospital stay of 2.38 days. Duration after which seton was removed ranged from 13 to 24 weeks with mean duration of 19.53 weeks and recurrence in the form of low fistulas was seen in 3 patients.
Conclusion: Use of loose setons in complex anal fistula is efficacious as a supplementary treatment in order to reduce recurrence rates and /or downstage the fistula.
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