PMID- 25997475
OWN - NLM
STAT- MEDLINE
DCOM- 20160802
LR  - 20151002
IS  - 1445-2197 (Electronic)
IS  - 1445-1433 (Linking)
VI  - 85
IP  - 10
DP  - 2015 Oct
TI  - Long-term results of the cutting seton for high anal fistula.
PG  - 720-7
LID - 10.1111/ans.13156 [doi]
AB  - BACKGROUND: No single procedure for high anal fistula delivers a high cure rate 
      while also completely protecting sphincter function. This paper reports our 
      long-term results with the cutting seton for high fistulae and draws comparisons 
      with advancement flap and ligation of intersphincteric fistula track (LIFT) 
      procedures. METHODS: A retrospective study of prospectively collected data in 
      consecutive patients undergoing treatment with cutting seton for high 
      cryptoglandular fistulae was carried out. A strict protocol dictated tightening 
      intervals of at least 4 weeks and no muscle division. In 59 patients 
      (male : female = 39:20) followed-up at mean 9.4 years (range 1.7-15.6 years) 
      healing rates, continence (St Mark's score 0-24), patient-perceived overall 
      change in bowel control (-5 to +5), faecal incontinence quality of life (FIQL) 
      and overall patient satisfaction (visual analogue score 0-10) were assessed. 
      RESULTS: Primary and secondary healing rates were 93% and 98%. Mean continence 
      score was 4.1, significantly worse in women than men (median 6, range 0-22 versus 
      median 1, range 0-17; P = 0.006). Seventy-eight per cent of patients had normal 
      continence or minor incontinence (score 0-6), 13.5% moderate incontinence (score 
      7-12) and 8.5% severe incontinence (score >12). Sixty-three per cent of patients 
      had no change or improved patient-perceived overall bowel control. Mean FIQL 
      scores were high and significantly correlated with continence. Median 
      satisfaction score was 9. CONCLUSION: Cutting seton for high anal fistula 
      achieved healing in 98% with good continence in the majority, particularly in 
      males, and a high level of patient satisfaction. Multicentre prospective studies 
      are needed to adequately compare cutting seton, flap and LIFT procedures.
CI  - (c) 2015 Royal Australasian College of Surgeons.
FAU - Patton, Vicki
AU  - Patton V
AD  - Department of Colorectal Surgery, St George Hospital, Sydney, New South Wales, 
      Australia.
AD  - University of New South Wales, Sydney, New South Wales, Australia.
FAU - Chen, Chung Ming
AU  - Chen CM
AD  - Department of Colorectal Surgery, St George Hospital, Sydney, New South Wales, 
      Australia.
AD  - Mount Elizabeth Novena Specialist Centre, Affinity Surgery Centre, Singapore.
FAU - Lubowski, David
AU  - Lubowski D
AD  - Department of Colorectal Surgery, St George Hospital, Sydney, New South Wales, 
      Australia.
AD  - University of New South Wales, Sydney, New South Wales, Australia.
LA  - eng
PT  - Journal Article
DEP - 20150521
PL  - Australia
TA  - ANZ J Surg
JT  - ANZ journal of surgery
JID - 101086634
SB  - IM
CIN - ANZ J Surg. 2015 Oct;85(10):697. PMID: 26429507
CIN - ANZ J Surg. 2016 Mar;86(3):208. PMID: 26940184
CIN - ANZ J Surg. 2016 Mar;86(3):209. PMID: 26940185
MH  - Adult
MH  - Aged
MH  - Fecal Incontinence/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Ligation/*methods
MH  - Male
MH  - Middle Aged
MH  - Patient Outcome Assessment
MH  - Patient Satisfaction
MH  - Quality of Life
MH  - Rectal Fistula/complications/*surgery
MH  - Recurrence
MH  - Retrospective Studies
MH  - *Surgical Flaps
MH  - Wound Healing/physiology
OTO - NOTNLM
OT  - anal fistula
OT  - complex anal fistula
OT  - seton
EDAT- 2015/05/23 06:00
MHDA- 2016/08/03 06:00
CRDT- 2015/05/23 06:00
PHST- 2015/03/23 00:00 [accepted]
PHST- 2015/05/23 06:00 [entrez]
PHST- 2015/05/23 06:00 [pubmed]
PHST- 2016/08/03 06:00 [medline]
AID - 10.1111/ans.13156 [doi]
PST - ppublish
SO  - ANZ J Surg. 2015 Oct;85(10):720-7. doi: 10.1111/ans.13156. Epub 2015 May 21.