Seton in Managing High Anal Fistula

Aims The aim of the present study was to evaluate the efficacy of loose Seton in the management of high anal fistula. Instrument & Methods A prospective cohort study of sixty-eight patients were studied, their ages ranging between 17-60 years, of both genders. All of them had a history of fistula in ano. 26 patients had high anal fistula managed by seton placement from February 2009 and February 2015. Findings Of these 68 patients, 51 were males, and 17 were females; the male to female ratio was 3:1. The incidence was low in both sexes below 20 years and after 50 years. Age peak occurrence was noted between 20 to 50 years. The median age was 41. Of 68 patients, 42 (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 opining. All patients with low types fistula (N=42) were treated by primary fistulotomy. Twenty-six patients with 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%). Conclusion 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 the treatment of a high type of anal fistula.