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Journal of Gastroenterology

, Volume 37, Issue 11, pp 912–915 | Cite as

Long-term results of seton drainage on complex anal fistulae in patients with Crohn's disease

  • Yoshio Takesue
  • Hiroki Ohge
  • Takashi Yokoyama
  • Yoshiaki Murakami
  • Yuji Imamura
  • Taijiro Sueda

Background:

The aim of this study was to assess the long-term (greater than 2 years) results of seton drainage on anal fistulae in patients with Crohn's disease. Methods: Between September 1990 and September 1999, 32 patients with Crohn's disease underwent seton drainage for complex anal fistulae. The median follow-up time in these patients was 62 months (range, 25–133 months). In 10 patients (31.3%), recurrent perineal abscesses occurred with inlying seton drainage, and these were drained by re-insertion of the seton. A Malecot catheter was also inserted in 8 patients with recurrence. Results: The overall success rate of long-term seton usage was 87.5%. The subsequent associated procedure was simple seton removal (n = 9), secondary core-out fistulectomy (n = 7), or lay-open fistulotomy (n = 4). Eleven patients still had the seton in place. Recurrence developed in 3 patients (33%) who underwent simple seton removal and in 2 patients (18.2%) who underwent the secondary core-out procedure or fistulotomy. At the last follow-up examination, continence had not changed in 28 (87.5%) of the 32 patients. No change in continence was experienced by 10 of the 11 patients who underwent secondary fistulotomy or the secondary core-out procedure. Conclusions: Long-term seton drainage for complex anal fistula in Crohn's disease is efficacious in both treating sepsis and preserving anal sphincter function. A relatively good result was achieved by the secondary core-out procedure or fistulotomy at the time of seton removal.

Key words: anal fistula Crohn's disease seton drainage continence 

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Copyright information

© Springer-Verlag Tokyo 2002

Authors and Affiliations

  • Yoshio Takesue
    • 1
  • Hiroki Ohge
    • 1
  • Takashi Yokoyama
    • 2
  • Yoshiaki Murakami
    • 1
  • Yuji Imamura
    • 1
  • Taijiro Sueda
    • 1
  1. 1. First Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, JapanJP
  2. 2. General Outpatient Department, Hiroshima University School of Medicine, Hiroshima, JapanJP

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