Personal technique for treatment of perianal fistulas in outpatients

Abstract

AIM: Presentation of a personal technique for the treatment of perineal fistulas in outpatients.

MATERIAL OF STUDY: 17 patients with complete non-complex linear intersphincteric or trans-sphincteric fistulas were treated with this technique. First we facilitated the cannulation, then we used the same catheters to place the “seton”.

We had to use a more subtle and smooth, rugged nylon thread, instead of the floss, due to the difference between the large size of the silk thread and the small lumen of the cannula.

RESULTS: The elastic traction has determined not only a valid mean of capillary drainage, but also a rapid passage through the tissues without any functional impairment, in times ranging from 2 to 4 weeks.

DISCUSSION: The traditional surgery is burdened by a significant number of relapses . This is due to the anatomical characteristics of the anal canal, to the difficulty to ensure the integrity of the sphincteric structures and to the position of the fistula. It’s essential to identify the whole extension of the fistula to avoid it’s partial removal and the persistence of granulation tissue therefore. With our technique, we got a good drainage of the fistula, avoiding to leave any residues or to create false paths causing relapses as may happen with the explorers.

CONCLUSIONS: The discomfort suffered by patients was minimal and the results achieved led us to support a greater diffusion of this technique in outpatients.