Elastic one-stage cutting seton for the treatment of high anal fistulas: preliminary results
The management of high and complicated anal fistulas remains a therapeutic challenge, and the oldest and theoretically the simplest technique is to use a seton. In this article, we document our recent experience in managing high anal fistulas with a simple modification of the cutting seton. Surgical...
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Veröffentlicht in: | Techniques in coloproctology 2004-11, Vol.8 (3), p.159-162 |
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description | The management of high and complicated anal fistulas remains a therapeutic challenge, and the oldest and theoretically the simplest technique is to use a seton. In this article, we document our recent experience in managing high anal fistulas with a simple modification of the cutting seton.
Surgical outcomes of patients treated by the elastic cutting seton for anal fistulas that involved more than half of the sphincter muscles or for anterior trans-sphincteric fistulas in female patients were analyzed. The elastic seton, which was created by cutting a thin (2-3 mm) circular strip from a surgical glove, including its thicker sleeve, was inserted through the remaining tract in a double-strand fashion, and then tied on the sphincter with two knots in a slightly tight manner.
Complete healing was achieved in 9 cases (45%) at 1 month and in all cases (100%) at 3 months postoperatively. Recurrent fistula was noted in a single patient (5%) at 8 months. Worsening of preoperative continence was noted in 4 patients (20%). However, the postoperative incontinence score (0.70+/-1.22) did not differ significantly from the preoperative score (0.41+/-0.41; p=0.059, Wilcoxon's test).
The preliminary results of this series suggest that the elastic cutting seton may be a valid alternative for the treatment of high anal fistulas. The possible positive contribution of the slow and stable cutting of the sphincter on the maintenance of continence is further supported. An important practical disadvantage of the conventional seton treatment, namely the need for postoperative adjustments, is also eliminated. |
doi_str_mv | 10.1007/s10151-004-0080-6 |
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Surgical outcomes of patients treated by the elastic cutting seton for anal fistulas that involved more than half of the sphincter muscles or for anterior trans-sphincteric fistulas in female patients were analyzed. The elastic seton, which was created by cutting a thin (2-3 mm) circular strip from a surgical glove, including its thicker sleeve, was inserted through the remaining tract in a double-strand fashion, and then tied on the sphincter with two knots in a slightly tight manner.
Complete healing was achieved in 9 cases (45%) at 1 month and in all cases (100%) at 3 months postoperatively. Recurrent fistula was noted in a single patient (5%) at 8 months. Worsening of preoperative continence was noted in 4 patients (20%). However, the postoperative incontinence score (0.70+/-1.22) did not differ significantly from the preoperative score (0.41+/-0.41; p=0.059, Wilcoxon's test).
The preliminary results of this series suggest that the elastic cutting seton may be a valid alternative for the treatment of high anal fistulas. The possible positive contribution of the slow and stable cutting of the sphincter on the maintenance of continence is further supported. An important practical disadvantage of the conventional seton treatment, namely the need for postoperative adjustments, is also eliminated.</description><identifier>ISSN: 1123-6337</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-004-0080-6</identifier><identifier>PMID: 15654522</identifier><identifier>CODEN: TECOFO</identifier><language>eng</language><publisher>Italy: Springer Nature B.V</publisher><subject>Adult ; Female ; Gloves, Surgical ; Humans ; Male ; Middle Aged ; Rectal Fistula - surgery ; Suture Techniques - instrumentation ; Treatment Outcome</subject><ispartof>Techniques in coloproctology, 2004-11, Vol.8 (3), p.159-162</ispartof><rights>Copyright Springer-Verlag 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c241t-65d4dcb3090d57f35f52de9004f2bbfd52f13034bee05744eb6cf0f9e7050f013</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15654522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mentes, B B</creatorcontrib><creatorcontrib>Oktemer, S</creatorcontrib><creatorcontrib>Tezcaner, T</creatorcontrib><creatorcontrib>Azili, C</creatorcontrib><creatorcontrib>Leventoğlu, S</creatorcontrib><creatorcontrib>Oğuz, M</creatorcontrib><title>Elastic one-stage cutting seton for the treatment of high anal fistulas: preliminary results</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><description>The management of high and complicated anal fistulas remains a therapeutic challenge, and the oldest and theoretically the simplest technique is to use a seton. In this article, we document our recent experience in managing high anal fistulas with a simple modification of the cutting seton.
Surgical outcomes of patients treated by the elastic cutting seton for anal fistulas that involved more than half of the sphincter muscles or for anterior trans-sphincteric fistulas in female patients were analyzed. The elastic seton, which was created by cutting a thin (2-3 mm) circular strip from a surgical glove, including its thicker sleeve, was inserted through the remaining tract in a double-strand fashion, and then tied on the sphincter with two knots in a slightly tight manner.
Complete healing was achieved in 9 cases (45%) at 1 month and in all cases (100%) at 3 months postoperatively. Recurrent fistula was noted in a single patient (5%) at 8 months. Worsening of preoperative continence was noted in 4 patients (20%). However, the postoperative incontinence score (0.70+/-1.22) did not differ significantly from the preoperative score (0.41+/-0.41; p=0.059, Wilcoxon's test).
The preliminary results of this series suggest that the elastic cutting seton may be a valid alternative for the treatment of high anal fistulas. The possible positive contribution of the slow and stable cutting of the sphincter on the maintenance of continence is further supported. An important practical disadvantage of the conventional seton treatment, namely the need for postoperative adjustments, is also eliminated.</description><subject>Adult</subject><subject>Female</subject><subject>Gloves, Surgical</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Rectal Fistula - surgery</subject><subject>Suture Techniques - instrumentation</subject><subject>Treatment Outcome</subject><issn>1123-6337</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkElLA0EQhRtRTIz-AC_SePA2Wr0n3iTEBQJeFDwIzSzVyYRZYnfPwX9vxwQED0XV4XuPeo-QSwa3DMDcBQZMsQxApplCpo_ImDE-zUCqj-PfW2RaCDMiZyFsAJgxip2SEVNaScX5mHwumjzEuqR9h1mI-QppOcRYdysaMPYddb2ncY00esxji12kvaPrerWmeZc31NUhDsninm49NnVbd7n_ph7D0MRwTk5c3gS8OOwJeX9cvM2fs-Xr08v8YZmVXLKYaVXJqiwEzKBSxgnlFK9wlmI5XhSuUtwxAUIWiKCMlFjo0oGboQEFDpiYkJu979b3XwOGaNs6lNg0eYf9EKw2nJsZyARe_wM3_eBTjmC5UEYrzU2C2B4qfR-CR2e3vm5TLMvA7nq3-95tetDuerc6aa4OxkPRYvWnOBQtfgCX0H4l</recordid><startdate>200411</startdate><enddate>200411</enddate><creator>Mentes, B B</creator><creator>Oktemer, S</creator><creator>Tezcaner, T</creator><creator>Azili, C</creator><creator>Leventoğlu, S</creator><creator>Oğuz, M</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200411</creationdate><title>Elastic one-stage cutting seton for the treatment of high anal fistulas: preliminary results</title><author>Mentes, B B ; Oktemer, S ; Tezcaner, T ; Azili, C ; Leventoğlu, S ; Oğuz, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-65d4dcb3090d57f35f52de9004f2bbfd52f13034bee05744eb6cf0f9e7050f013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Female</topic><topic>Gloves, Surgical</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Rectal Fistula - surgery</topic><topic>Suture Techniques - instrumentation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mentes, B B</creatorcontrib><creatorcontrib>Oktemer, S</creatorcontrib><creatorcontrib>Tezcaner, T</creatorcontrib><creatorcontrib>Azili, C</creatorcontrib><creatorcontrib>Leventoğlu, S</creatorcontrib><creatorcontrib>Oğuz, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mentes, B B</au><au>Oktemer, S</au><au>Tezcaner, T</au><au>Azili, C</au><au>Leventoğlu, S</au><au>Oğuz, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elastic one-stage cutting seton for the treatment of high anal fistulas: preliminary results</atitle><jtitle>Techniques in coloproctology</jtitle><addtitle>Tech Coloproctol</addtitle><date>2004-11</date><risdate>2004</risdate><volume>8</volume><issue>3</issue><spage>159</spage><epage>162</epage><pages>159-162</pages><issn>1123-6337</issn><eissn>1128-045X</eissn><coden>TECOFO</coden><abstract>The management of high and complicated anal fistulas remains a therapeutic challenge, and the oldest and theoretically the simplest technique is to use a seton. In this article, we document our recent experience in managing high anal fistulas with a simple modification of the cutting seton.
Surgical outcomes of patients treated by the elastic cutting seton for anal fistulas that involved more than half of the sphincter muscles or for anterior trans-sphincteric fistulas in female patients were analyzed. The elastic seton, which was created by cutting a thin (2-3 mm) circular strip from a surgical glove, including its thicker sleeve, was inserted through the remaining tract in a double-strand fashion, and then tied on the sphincter with two knots in a slightly tight manner.
Complete healing was achieved in 9 cases (45%) at 1 month and in all cases (100%) at 3 months postoperatively. Recurrent fistula was noted in a single patient (5%) at 8 months. Worsening of preoperative continence was noted in 4 patients (20%). However, the postoperative incontinence score (0.70+/-1.22) did not differ significantly from the preoperative score (0.41+/-0.41; p=0.059, Wilcoxon's test).
The preliminary results of this series suggest that the elastic cutting seton may be a valid alternative for the treatment of high anal fistulas. The possible positive contribution of the slow and stable cutting of the sphincter on the maintenance of continence is further supported. An important practical disadvantage of the conventional seton treatment, namely the need for postoperative adjustments, is also eliminated.</abstract><cop>Italy</cop><pub>Springer Nature B.V</pub><pmid>15654522</pmid><doi>10.1007/s10151-004-0080-6</doi><tpages>4</tpages></addata></record> |
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subjects | Adult Female Gloves, Surgical Humans Male Middle Aged Rectal Fistula - surgery Suture Techniques - instrumentation Treatment Outcome |
title | Elastic one-stage cutting seton for the treatment of high anal fistulas: preliminary results |
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