Abdul Razaque Qazi, Jan Muhammad Memon, Roshan Ali Solangi, Syed Qaiser Hussain Naqvi.
Outcome analysis of partial Fistulotomy with Seton.
Pak J Surg Jan ;24(1):15-8.

Objective: To evaluate the effectiveness of cutting seton in the treatment of high anal fistulae. Design & Duration: Quasi experimental study from Jan. 2004 to Jan. 2007. Setting: Department of Surgery, Unit III, Nawabshah Medical College & Hospital, Nawabshah. Patients: All cases with high anal fistula. Methodology: After clinical work-up all patients with high anal fistula were treated with cutting seton; the material used was metal wire. A probe was introduced through the external opening and the tract was laid open over a grooved probe up to the dentate line, subsequently seton was introduced through the external opening and brought out of the anus through internal opening and tied at the anal verge. After every fortnight the seton was tightened, till it cut through the tract. Results: Out of the total 25 patients, 20(80%) were male and 5(20%) were female. Their ages ranged between 20 to 60 years, with a mean age of 38 years. The duration of symptoms varied from 3-24 months. The chief complaints were perianal discharge, swelling, pain and perianal excoriation. The fistula healed completely in 21(84%) patients; 3(12%) patients experienced some degree of incontinence to flatus but none to faeces. One patient developed recur- rence of the fistula. Conclusion: Treatment of high anal fistula by staged fistulotomy with cutting seton is very rewarding, with minimum postoperative complications.

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