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  • Title: Functional results after seton treatment of high transsphincteric anal fistulas.
    Author: Graf W, Påhlman L, Ejerblad S.
    Journal: Eur J Surg; 1995 Apr; 161(4):289-91. PubMed ID: 7612773.
    Abstract:
    OBJECTIVE: To evaluate the functional outcome after seton treatment of high transsphincteric anal fistulas. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: 29 patients (8 women, mean age 46, range 25-71) with high transsphincteric anal fistulas 1983-1992. INTERVENTIONS: Setons were inserted in the anal fistulas in all patients. MAIN OUTCOME MEASURES: Anal continence evaluated by a questionnaire a mean of 46 months postoperatively. Clinical data were collected from the patients' records. RESULTS: All four patients with inflammatory bowel disease had some incontinence. Of the remaining 25 patients, 11 (44%) complained of incontinence and 2 (8%) developed recurrent fistulas. Incontinence was more common when the seton was tightened at the last procedure (7/9) compared with those in which the tissue enclosed by the seton was divided (4/16, p = 0.03). No other preoperative or operative characteristic significantly influenced the risk of incontinence. CONCLUSION: Incontinence is common after seton treatment of high transsphincteric anal fistulas. The risk seems to be higher when the muscle remains viable after a period of seton treatment.
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