Long-term, indwelling setons for low transsphincteric and intersphincteric anal fistulas - Experience with 108 cases

PURPOSE: The purpose of this study was to determine the technique and results of long-term, indwelling setons for low transsphincteric and intersphincteric anal fistulas. METHOD: Long-term, indwelling setons were performed in 108 consecutive patients with low transsphincteric and intersphincteric anal fistulas. Progress and results of 73.1 percent of cases were assessed in a retrospective study. RESULTS: Therapy lasted for an average of 54.8 weeks; mean follow-up was 62 weeks. Relapse occurred in 3.7 percent of cases and incontinence in 0.9 percent. Average period spent in a hospital was 0.3 days/case. CONCLUSIONS: A long-term, indwelling seton is a good alternative to primary surgical treatment of low transsphincteric and intersphincteric anal fistulas. Relapse quota is comparable with that of primary surgically treated cases; incontinence is rarer with long-term, indwelling seton. Complete treatment can generally be performed in the outpatient department. One disadvantage is that therapy takes much longer than cases treated by primary surgery.