The effect of hybrid seton on anal continence and quality of life in transsphincteric fistulas. Long-term follow-up

Abstract

BACKGROUND: The aim of this study is to evaluate long-term results of hybrid seton on anal continence and quality of life in transsphincteric fistulas. 

METHODS: Between 2011-2013 eighty patients who completed 7-year follow-up among 154 patients who were operated for perianal fistula were included. Of the 50 patients participating, 42 (84%); 31 men, 11 women) returned all questionnaraires. The proctological findings of the patients were compared with the newly obtained ones retrospectively. Demographic characteristics of the patients, preoperative and postoperative 3rd month and 7th year Cleveland Clinic Incontinence Score, preoperative and postoperative 3rd month and 7th year Fecal Incontinence Quality of Life and seton fall times were assessed. 

RESULTS: Thirty (73.8%) of 42 patients were male and 11 (26.2%) were female. The mean age of male patients was 36.3 ± 10.3 (18-57), and the mean age of female patients was 41.2 ± 12.1 (25-64) years. The mean time drop off the elastic seton was 19 ± 2.40 days (range 12-30 days). The preoperative and postoperative 3rd month Fecal Incontinence Quality of Life values™ were compared and improvement in lifestyle quality at the postoperative 3rd month was found to be statistically significant (p <0.01). When the preoperative and postoperative 7th year were compared in terms of Fecal Incontinence Quality of Life, behavior, life style and depression improved positively (p <0.01). 

CONCLUSION: Hybrid seton in transsphincteric perianal fistula surgery is an effective and reliable method for preserving anal continence and improving quality of life.