Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3319539 | Seminars in Colon and Rectal Surgery | 2009 | 8 Pages |
Abstract
Setons in the treatment of fistula-in-ano have been used for thousands of years. Although there are few high-quality prospective trials, there are numerous retrospective series documenting high cure rates of more than 90% with cutting setons or two stage seton fistulotomy. Both techniques, however, result in a variable rate of incontinence, higher with two stage seton fistulotomy where the internal anal sphincter is routinely divided. Incontinence rates for slow cutting setons are 10%-20% for minor incontinence with rates of 0%-10% for major incontinence; compared to rates of more than 35% and as high as 70% with the two-stage technique. Loose draining setons have an important role the management of Crohn's disease and can result in good palliation with minimal risk of deterioration of bowel control.
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Authors
Christopher M. MBBS, BSc(med), MS, FRACS, Michael J. MBBCh (Hons), MSc, FRACS,