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Identification of the internal anal opening and seton placement improves the outcome of deep postanal space abscess
Author(s) -
Tan K.K.,
Liu X.,
Tsang C. B.,
Koh D. C.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12076
Subject(s) - medicine , surgery , drainage , abscess , retrospective cohort study , ecology , biology
Aim This study aimed to determine if successful seton placement at the initial drainage procedure improves outcomes in the management of deep postanal space abscesses. Method A retrospective review was performed of all patients who underwent initial drainage of a DPA space abscess between D ecember 2002 and A ugust 2010. A seton was placed through the internal opening if it could be identified. Results Thirty‐two patients of median age 41 (21–64) years formed the study group. Twenty‐four (75.0%) had a seton inserted at the initial drainage procedure. The patients underwent a total of 56 operations. The median interval from the initial to the final operation was 5 (2–18) months with 17 (70.8%) patients having the final operation within 6 months. In the 8 (25.0%) patients whose internal opening could not be found, 26 operations were required with a median interval from the initial to the final surgery of 11 (3–24) months. Patients who had a seton successfully inserted at drainage underwent significantly earlier definitive surgery and required fewer operations ( P < 0.038). Conclusion Identification of an internal opening with placement of a seton at the initial drainage procedure is associated with earlier definitive surgery and fewer operations.