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Ambulatory Seton Placement Followed by Fistulotomy: Efficacy and Safety for Perianal Fistula Treatment

2021Journal article Open access
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dc.contributor.authorGamelas, V
dc.contributor.authorSantos, S
dc.contributor.authorLoureiro, R
dc.contributor.authorSeves, I
dc.contributor.authorCosta Simões, J
dc.contributor.authorBettencourt, MJ
dc.date.accessioned2022-03-14T15:20:09Z
dc.date.available2022-03-14T15:20:09Z
dc.date.issued2021
dc.description.abstractPurpose: To evaluate the efficacy and safety of ambulatory seton placement followed by superficial fistulotomy as treatment of perianal fistula. Methods: Retrospective observational analysis of patients with cryptogenic perianal fistula aged 18-90 years, followed in a central hospital proctology consultation between 2006 and 2017. Data were obtained through clinical record's analysis. Fistula was characterized, using Parks Classification. A probe was passed through the fistula tract, followed by a seton, which remained in situ until superficial fistulotomy was possible. Results: Ninety-six patients were included (66.67% males, mean age 56 ± 15 years old). Nineteen patients (19.89%) had previous history of perianal fistula and 14 (14.58%) previous anorectal surgery. Seventy-four patients (78.72%) were submitted to fistulotomy, three (3.19%) had seton fistulotomy and one had no seton progression. Intention-to-treat and per-protocol efficacy analyses were 80.2 and 98.7%, respectively. Among the 74 patients who completed the procedure, type of fistula and time with seton were distributed as followed: 47 (63.51%) intersphincteric fistula (15 ± 31 weeks), 26 (35.14%) transsphincteric fistula (32 ± 47 weeks), one (1.35%) suprasphincteric fistula (11 weeks). Previous fistula was associated with a longer time with seton (P = 0.018). Incontinence was reported in two (2.7%) patients, who had previous perianal fistula or anorectal surgery. Two patients (2.7%) had recurrence after fistulotomy. Conclusion: Placement of seton followed by superficial fistulotomy in an ambulatory setting is a safe and effective method for simple low perianal fistula treatment. Incontinence rate may be higher in patients with previous perianal fistula or anorectal surgery.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Gastroenterol Hepatol . 2021 Jul 1;33(7):956-960pt_PT
dc.identifier.doi10.1097/MEG.0000000000001913pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWolters Kluwerpt_PT
dc.subjectFistulotomypt_PT
dc.subjectPerianal fistula/treatmentpt_PT
dc.subjectCHULC GASpt_PT
dc.titleAmbulatory Seton Placement Followed by Fistulotomy: Efficacy and Safety for Perianal Fistula Treatmentpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage960pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage956pt_PT
oaire.citation.volume33pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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