Medium- to long-term outcomes of seton placement for fistula-in-ano in children: the experience of 103 patients from a single institution
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In brief
In brief
This retrospective study of 103 pediatric patients demonstrates that seton placement is a safe and effective treatment for anal fistula in children, with a 94% primary healing rate and median healing time of four weeks over a 23-month follow-up period. The technique successfully managed both simple and complex fistulas with minimal recurrence.
- Seton placement achieved successful healing in 94% (97/103) of pediatric anal fistula cases with median 4-week healing time.
- Staged seton placement is preferred for multiple fistulas; primary placement works well for single or double fistulas.
- Recurrence rate was low (2%) with only 2 patients requiring second seton placement during 23-month median follow-up.
- Poor healing occurred in 4% of cases but resolved with conservative management (dressing changes and debridement).
- Seton technique is safe and effective for pediatric fistula-in-ano, avoiding sphincter damage risks of other surgical approaches.
Written by the GCMD Library team from the article.
Abstract
Purpose
The aim of this study was to evaluate the efficacy of seton placement for anal fistula in children.
Methods
The clinical data of children with anal fistula treated by seton placement admitted from January 2017 to September 2022 were retrospectively analyzed. Our primary treatments for perianal abscess (PA) are conservative treatment and drainage. Patients with systemic and inflammatory bowel diseases were excluded.
Results
The median follow-up time of these patients was 23 (6–58) months, and the median onset age was 16 (3–156) months. Among the 103 patients, 75 with a single fistula and 20 with a double fistula were treated by primary seton placement. Seven patients with multiple fistulas were treated using staged seton placement, and one case using primary seton placement. A total of 97 patients experienced good healing, four patients experienced poor healing and healed after dressing change and debridement, and two patients with multiple fistulas who experienced recurrence underwent a second seton placement. The average healing time was four (1–10) weeks.
Conclusion
The medium- to long-term outcome of seton placement indicates that this procedure is safe and effective in the treatment of anal fistula in children.