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Hybrid seton for the treatment of high anal fistulas: results of 128 consecutive patients Ege B; Leventoglu S; Mentes BB; Yilmaz U; Oner AYTech Coloproctol 2014[Feb]; 18 (2): 187-93BACKGROUND: 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.|*Suture Techniques[MESH]|Adult[MESH]|Aged[MESH]|Cutaneous Fistula/complications/*surgery[MESH]|Depression/psychology[MESH]|Fecal Incontinence/etiology/*psychology[MESH]|Female[MESH]|Humans[MESH]|Life Style[MESH]|Male[MESH]|Middle Aged[MESH]|Pain Measurement[MESH]|Pain, Postoperative/etiology[MESH]|Quality of Life/psychology[MESH]|Rectal Fistula/complications/*surgery[MESH]|Recurrence[MESH]|Retrospective Studies[MESH]|Severity of Illness Index[MESH]|Young Adult[MESH] |
