Expérience du séton constricteur dans le traitement des fistules anales transsphinctériennes hautes

Abstract

The aim of this study was to report our experience of the use of the cutting seton in the treatment of high transsphincteric anal fistula. It was a retrospective study from January 2006 to September 2011. All files
of patients with high transsphincteric crypto glandular anal fistula who were operated on by the cutting seton technique were analyzed. There were 38 males and 8 females with a mean age of 36.2 years. Assessment of
results concerned post operative complications, time of cutting sphincteric muscle by the seton, delay of recovery, anal incontinence and recurrence rates. The mean of follow up duration was 9 months (6 to 15). Forty six patients were operated on according to this procedure. Thirteen of them (28.3%) were HIV positive. In earlier post operative period, 3 cases of
urinary retention were observed in patients in whom rachidian anesthesia was performed. Hospital stay duration was 2 to 3. Complete section of sphincter muscle with drop of seton occurred in a mean period of 14 days (range: 7 to 37). Complete recovery was observed in one month’s period in 17 (37%) patients and in three months’ period in other patients. No
recurrence occurred and anal continence was preserved. This preliminary study revealed that the cutting seton procedure was efficient in the treatment of upper transsphincterian anal fistula. Our results suggest that this procedure might remain a good alternative procedure in our context.

Key words: Anal fistula, fistulotomy, seton, recurence, anal incontunence.