Effectiveness of Partial Fistula Tract Excision with Loose Seton Implantation to Treat Perianal Fistula

Abstract

Objective: Perianal fistula is an anorectal disease that can significantly impair quality of life. The course of the disease can include chronic exacerbation and recurrence. Many surgical techniques have been developed to treat perianal fistula, but reappearance of the fistula is still a major problem. The aim of the present study was to evaluate the results of partial fistula tract excision (partial fistulectomy) and loose seton application in the treatment of primary and recurrent perianal fistula. Materials and Methods: Forty-two patients with a primary or recurrent perianal fistula who underwent a partial fistulectomy with loose seton placement at a single clinic between January 2015 and March 2020 were included. Clinical and demographic characteristics including the fistula location, postoperative recurrence, anal incontinence, and satisfaction rate were evaluated retrospectively. Results: Of the 42 patients, 15 were female and 27 were male. The mean age was 43.4 +/-.13.1 years and the median follow-up period was 10 months (range: 5-21 months). No statistically significant difference in disease recurrence was found in terms of age, sex, American Society of Anesthesiologists classification, smoking, abscess history, fistula type, or primary/recurrence status (p>0.05). Total anal incontinence did not develop in any patient during the follow-up period. Recurrence of perianal fistula was observed in 2 patients (4.8%). Conclusion: The results of the present study indicated that partial fistula tract excision and loose seton implantation remains the primary treatment method of choice due to the low rate of recurrence and incontinence coupled with high patient satisfaction.