Annals of Coloproctology

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Original Article

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients: Bader Hamza Shirah, Hamza Asaad Shirah; Ann Coloproctol. 2018;34(5):234-240. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2018.03.23

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15 Citations

Purpose
A cutting seton is used after a partial distal fistulotomy to treat patients with a high exrasphincteric fistula in ano to avoid fecal incontinence and recurrence. In Saudi Arabia, religious practices necessitate complete cleanness, which makes conditions affecting anal continence a major concern to patients affected by an anal fistula. Therefore, we aimed to evaluate the efficiency of the cutting seton in treating a high anal fistula among Saudi Arabians.
Methods
Between January 2005 and December 2014, a prospective study was done for 372 Saudi Arabian patients diagnosed as having a high anal fistula and treated with a cutting seton at Al-Ansar General Hospital, Medina, Saudi Arabia. 0-silk sutures were used. All patients underwent the same preoperative assessment, operative technique, and postoperative follow-up. Weekly, the seton was tightened in outpatient clinics.
Results
Two hundred ninety-eight patients (80.1%) were males and 74 (19.9%) females. The duration of symptoms varied from 3–21 months. The fistula healed completely in 363 patients (97.6%); 58 patients (15.6%) reported some degree of incontinence to flatus, but none to feces. In 9 patients (2.4%) the fistula recurred.
Conclusion
The utilization of the cutting seton method in the treatment of patients with a high anal fistula is highly efficient as it simultaneously drains the abscess, cuts the fistulous tract, and causes fibrosis along the tract. Treatment of a high anal fistula by using a staged fistulotomy with a cutting seton was very rewarding to Saudi Arabian patients who feared anal incontinence for religious reasons and was associated with low postoperative complication and recurrence rates.

Citations

Citations to this article as recorded by

Ultrasound assessment of low type intersphincteric perianal fistulas in Yemen
Sultan Abdulwadoud Alshoabi, Abdulkhaleq Ayedh Binnuhaid, Abdullgabbar M. Hamid, Fahad H. Alhazmi, Abdulaziz A. Qurashi, Awadia Gareeballah, Moawia Gameraddin, Osamah M. Abdulaal, Walaa Alsharif, Fathelrehman A. Elajab, Tareef S. Daqqaq, Khaled Mohammed A
Scientific Reports.2025;[Epub] CrossRef
Cutting seton for the treatment of cryptoglandular fistula-in-ano: a systematic review and meta-analysis
J. Khamar, A. Sachdeva, T. McKechnie, Y. Lee, L. Tessier, D. Hong, C. Eskicioglu
Techniques in Coloproctology.2024;[Epub] CrossRef
Evaluation surgical strategies in perianal fistulas treatment: Efficacy draining seton compared to other surgical approaches; a case‐control study
Amir Ghasemlouei, Amirhosein Naseri, Ali Ashjaei, Shahryar Sadeghi, Amir Keshvari
Health Science Reports.2024;[Epub] CrossRef
Assessing the suitability of video-assisted anal fistula treatment for obese patients compared to conventional surgery: a question worth investigating
Xiao-Li Tang, Zi-Yang Xu, Jun Yang, Zhe Yang, Zhi-Gang Wang, Zheng-Yun Zhang, Jing Yao
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial
Jiawei Qin, Yanlan Wu, Xueping Zheng, Kunlan Wu, Gongjian Dai, Yanyan Tan, Xu Yang, Yuqing Sun
Journal of the American College of Surgeons.2024; 239(6): 563. CrossRef
Fistulectomy and primary sphincteroplasty in complex anal fistula treatment: a hospital-based long-term follow-up study
Fakhrosadat Anaraki, Mohammad Reza Nikshoar, Arsh Haj Mohamad Ebrahim Ketabforoush, Rojin Chegini, Nasrin Borumandnia, Mehdi Tavallaei
Techniques in Coloproctology.2023; 27(2): 145. CrossRef
Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
Life.2023; 13(10): 2008. CrossRef
Surgical treatment of anal fistula
A. Ya. Ilkanich, V. V. Darwin, E. A. Krasnov, F. Sh. Aliyev, K. Z. Zubailov
Сибирский научный медицинский журнал.2023; 43(5): 74. CrossRef
Evaluation of the Cutting Seton Technique in Treating High Anal Fistula
Asim M Almughamsi, Mohamed Khaled S Zaky, Abdullatif M Alshanqiti, Ibrahim S Alsaedi, Hamed I Hamed, Tariq E Alharbi, Ali A Elian
Cureus.2023;[Epub] CrossRef
Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub] CrossRef
Evaluating the Efficacy of Cutting Setons for the Treatment of Anal Fistulas
Miguel E. Gomez, Koianka Trencheva, Matthew Symer, Kelly Garrett, Jeffrey W. Milsom, Parul J. Shukla
Indian Journal of Surgery.2022; 84(5): 961. CrossRef
Advancing standard techniques for treatment of perianal fistula; when tissue engineering meets seton
Hojjatollah Nazari, Zahra Ebrahim Soltani, Reza Akbari Asbagh, Amirsina Sharifi, Abolfazl Badripour, Asieh Heirani Tabasi, Majid Ebrahimi Warkiani, Mohammad Reza Keramati, Behnam Behboodi, Mohammad Sadegh Fazeli, Amir Keshvari, Mojgan Rahimi, Seyed Mohsen
Health Sciences Review.2022; 3: 100026. CrossRef
Treatment of the fistula tract with laser ablation in high anal fistula
Erkan Karacan, Eyüp Murat Yılmaz
Journal of Clinical Medicine of Kazakhstan.2022; 19(6): 43. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
Journal of Coloproctology.2020; 40(01): 056. CrossRef
A Commentary on the article: “Risk factors for recurrence after anal fistula surgery: A meta-analysis”, Int J Surg 2019;69:153–164
F. Karimian
International Journal of Surgery.2019; 71: 79. CrossRef

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