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The Use of a Staged Drainage Seton for the Treatment of Anal Fistulae or Fistulous Abscesses

대한대장항문학회지 2012년 28권 6호 p.309 ~ 314
임청호 ( Lim Cheong-Ho ) - 양병원 대장항문외과

신현근 ( Shin Hyeon-Keun ) - 양병원 대장항문외과
강욱호 ( Kang Wook-Ho ) - 양병원 대장항문외과
박찬호 ( Park Chan-Ho ) - 양병원 대장항문외과
홍사민 ( Hong Sa-Min ) - 양병원 대장항문외과
정승규 ( Jeong Seung-Kyu ) - 양병원 대장항문외과
김준영 ( Kim June-Young ) - 양병원 대장항문외과
양형규 ( Yang Hyung-Kyu ) - 양병원 대장항문외과

Abstract


Purpose: The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.

Methods: According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.

Results: The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.

Conclusion: In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.

키워드

Seton; Surgical drainage; Fistula; Perianal abscess
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