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Seton (Loose, Cutting, Chemical)

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Anal Fistula

Abstract

Setons for anal fistula have been used since many millennia. Healing, recurrence, and incontinence rates vary depending on the surgical technique, level of fistula, and the surgeon’s experience. There is paucity of Level 1 literature regarding outcomes following seton insertion. Setons can be used to prevent recurrence of sepsis following drainage of abscess, to promote maturation of the track before a definite procedure, as a controlled fistulotomy (cutting seton) in cases where there is a high risk of incontinence with single-stage fistulotomy and lastly in complex fistula patients when all other modalities have failed. Recurrence rates are low with cutting and chemical setons, however the minor incontinence rates can be high. Cornerstone of fistula management is surgeon’s and patient appreciation of the balance between fistula healing and risk of incontinence.

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Authors and Affiliations

  1. James Paget University Hospitals Foundation Trust, Lowestoft Road, Gorleston, Great Yarmouth, Norfolk, UK, NR31 6LA

    Vamsi R. Velchuru M.B.B.S, F.R.C.S. (Edin.), F.R.C.S. (Gen. Surg.)

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  1. Vamsi R. Velchuru M.B.B.S, F.R.C.S. (Edin.), F.R.C.S. (Gen. Surg.)
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Correspondence to Vamsi R. Velchuru M.B.B.S, F.R.C.S. (Edin.), F.R.C.S. (Gen. Surg.) .

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  1. Division of Colon and Rectal Surgery, The University of Illinois at Chicago, Chicago, Illinois, USA

    Herand Abcarian

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Velchuru, V.R. (2014). Seton (Loose, Cutting, Chemical). In: Abcarian, H. (eds) Anal Fistula. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9014-2_8

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  • DOI: https://doi.org/10.1007/978-1-4614-9014-2_8

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