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  • Title: Long-term results of seton drainage on complex anal fistulae in patients with Crohn's disease.
    Author: Takesue Y, Ohge H, Yokoyama T, Murakami Y, Imamura Y, Sueda T.
    Journal: J Gastroenterol; 2002; 37(11):912-5. PubMed ID: 12483246.
    Abstract:
    BACKGROUND: The aim of this study was to assess the long-term (greater than 2 years) results of seton drainage on anal fistulae in patients with Crohn's disease. METHODS: Between September 1990 and September 1999, 32 patients with Crohn's disease underwent seton drainage for complex anal fistulae. The median follow-up time in these patients was 62 months (range, 25-133 months). In 10 patients (31.3%), recurrent perineal abscesses occurred with inlying seton drainage, and these were drained by re-insertion of the seton. A Malecot catheter was also inserted in 8 patients with recurrence. RESULTS: The overall success rate of long-term seton usage was 87.5%. The subsequent associated procedure was simple seton removal ( n = 9), secondary core-out fistulectomy ( n = 7), or lay-open fistulotomy ( n = 4). Eleven patients still had the seton in place. Recurrence developed in 3 patients (33%) who underwent simple seton removal and in 2 patients (18.2%) who underwent the secondary core-out procedure or fistulotomy. At the last follow-up examination, continence had not changed in 28 (87.5%) of the 32 patients. No change in continence was experienced by 10 of the 11 patients who underwent secondary fistulotomy or the secondary core-out procedure. CONCLUSIONS: Long-term seton drainage for complex anal fistula in Crohn's disease is efficacious in both treating sepsis and preserving anal sphincter function. A relatively good result was achieved by the secondary core-out procedure or fistulotomy at the time of seton removal.
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