Aim: In our prospective study the method of partial distal fistulotomy and modified cutting seton for high extrasphincteric perianal fistulae is discussed. Methods: 10 patients (9 males and 1 female) with high extrasphincteric perianal fistulae were treated with partial distal fistulotomy and modified cutting seton. Four or five threads were introduced through the tract; one was tied tightly at the end of the operation, others were tightened every 10th day. While the tied thread cut the tissue, the others drained the tract. The follow-up period ranged from 3 months to 9 years. Results: None of the patients developed major fecal incontinence. 2 of the 10 patients complained of incontinence due to flatus. Conclusion: Distal fistulotomy and modified cutting seton can be used in perianal fistulae with high anal or rectal opening, because it combines the effects of both cutting and loose setons and because the postoperative results regarding continence are satisfactory.

Keywords:
Perianal fistula, Fistulotomy, Seton
1.
Lunniss PJ, Thompson JPS: The loose seton; in Phillips RKS, Lunniss PJ (eds): Anal Fistula. London, Chapman & Hall, 1996, pp 87–94.
2.
Goldberg SM, Aguilar JG: The cutting seton; in Philllips RKS, Lunniss PJ (eds): Anal Fistula. London, Chapman & Hall, 1996, pp 95–102.
3.
McCourtney JS, Finlay IG: Setons in the surgical management of fistula in ano. Br J Surg 1995;82:448–452.
4.
McCourtney JS, Finlay IG: Cutting seton without preliminary internal sphincterotomy in management of complex high fistula-in-ano. Dis Colon Rectum 1996;39:55–58.
5.
Pearl RK, Andrews JR, Orsay CP, Weisman RI, Prasad ML, Nelson RL, Cintron JR, Abcarian H: Role of the seton in the management of anorectal fistula. Dis Colon Rectum 1993;36:573–579.
6.
Williams JG, Macleod CA, Rothenberger DA, Goldberg SM: Seton treatment of high anal fistulae. Br J Surg 1991;78:1159–1161.
7.
Hanley PH: Rubber band seton in the management of abscess and anal fistula. Ann Surg 1978;187:435–437.
8.
Pikarsky AJ, Nogueras JJ, Wexner SD: Surgical workshop: A new modification with the use of a seton in treating anal fistula. Tech Coloproctol 2000;4:109–110.
© 2002 S. Karger AG, Basel
2002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.