Seton treatment of anal fistula: experience with a new modification

Objective: To describe a modified method of seton treatment of anal fistula. Design: Retrospective study. Setting: Teaching hospital, Poland. Subjects: 33 patients operated on for anal fistulas between January 1992 and September 1996. Interventions: A modified seton technique in which a rubber band was pulled through fistulous track and tightened around the external sphincter by a thread tied around its ends. Main outcome measures: Anal incontinence, fistula recurrences. Results: Of the 33 patients, 22 had high trans‐sphincteric, 4 had suprasphincteric, and 7 had extrasphincteric fistulas. No fistula recurred. All patients were sent a questionnaire and 32 replied (97%). 26 patients had normal control of solid stool. 1 was incontinent less than once a week, and 5 less than once a month. 20 patients were continent to liquid stool. 3 patients experienced problems controlling liquid stool less than once a week, and 9 less than once a month. 21 patients had normal control of flatus. 9 experienced minor soiling. Conclusion: The method is simple, therapeutic results are satisfactory, and patients tolerate the procedure well. We recommend it in any case in which total fistulectomy cannot be done because of the risk of incontinence. Copyright © 1998 Taylor and Francis Ltd.