A Seton in Managing High Anal Fistula

The aim of the present study was to evaluate the efficacy of loose Seton in managing high anal fistula.

A prospective cohort study of sixty-eight patients was studied, their ages ranging between 17-60 years, of both genders. All of them had a history of fistula in ano. Twenty-six patients had high anal fistula managed by seton placement from February 2015 and February 2021.

Fifty-one patients were males, and 17 were females. The incidence was low in both sexes below 20 years and after 50 years. Forty-two patients (61.8%) had low fistula, 26 (38.2%) had high fistula, 23 (33.8) with a single opening, 3 (4.4%) patients had high fistula with multiple openings. All patients with low fistula (n=42) were treated by primary fistulotomy. Twenty-six patients had a high type of fistula in ano treated with Seton. Minor incontinence was noted in two patients. These patients lost control of flatus which persisted for four months. No fecal incontinence was noticed in any patient. In 21 cases with high fistula in ano were successfully eliminated (Successful rate=81%) by Seton treatment alone. While recurrence fistula in five patients (Failure rate=19%).

This method provides an alternative to the conventional operative treatment for high anal fistulae. The results from the use of loose Seton are safe and effective in treating a high type of anal fistula.