Hybrid seton for the treatment of high anal fistulas: results of 128 consecutive patients.
Tech Coloproctol
; 18(2): 187-93, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-23633241
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate our experience in managing high anal fistulas with a simple modification of the cutting seton.METHODS:
We performed a retrospective review of standardized patient charts and of prospectively collected scores and questionnaires. Surgical outcomes of 128 consecutive, well-documented patients with high anal fistulas, including anterior transsphincteric fistulas in females, treated using a hybrid seton, were analyzed.RESULTS:
No significant complications occurred. The mean postoperative pain scores on a visual analog scale were 3.23 and 0.61, on days 1 and 7, respectively. Complete healing was achieved in 67 cases (52.3 %) at 1 month and in all cases (100 %) at 3 months. Recurrent fistula was noted in 2 patients (1.5 %) at 6 and 12 months. The mean postoperative incontinence scores at 3 and 12 months did not differ significantly from the preoperative score (p = 0.061, Wilcoxon's test). The depression, life style, and embarrassment item scores of the fecal incontinence quality of life index improved significantly after surgical treatment.CONCLUSIONS:
The results of this series suggest that the hybrid seton might be a valid alternative for the treatment of high anal fistulas, eliminating the need for postoperative adjustments. The slow and stable cutting of the sphincter seems to have a positive effect on the maintenance of continence. The successful outcome is associated with significant improvement in quality of life.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Técnicas de Sutura
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Fístula Retal
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Fístula Cutânea
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Incontinência Fecal
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article