Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence
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Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence. / Schrader, Lisa; Brandstrup, Birgitte; Olaison, Gunnar.
I: Langenbeck's Archives of Surgery, Bind 408, Nr. 1, 352, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence
AU - Schrader, Lisa
AU - Brandstrup, Birgitte
AU - Olaison, Gunnar
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Purpose: To investigate the ability of a “slowly cutting, loose seton ligature and staged fistulotomy” to heal perianal fistulas, the time needed with the seton ligature, recurrence rate, influence on anal continence, health-related quality of life (HRQoL), and patient satisfaction. Methods: Observational single-center study. We reviewed the medical records of all patients with primary surgeries from January 1, 2009, to December 31, 2018. The patients answered a questionnaire pre- and postoperative on anal continence (St. Mark’s incontinence score) and HRQoL (The Short Health Scale). Satisfaction with the operation was answered postoperatively. Results: Forty-three patients (37 men, 6 women) were included. Initially 41 of 43 healed (95%). Three patients (7%) had a recurrence, two healed after retreatment. The median follow-up was 55 months (IQR, 4). Thirty-four patients (79%) responded to the questionnaire. At follow-up, forty (93%) patients were healed. The median time treated with a seton ligature in the healed patients was 13 months (IQR, 14). St. Mark’s incontinence score preoperative was median 2 (IQR, 9) and after the operation median 1 (IQR, 4). The Short Health Scale improved from median 20 (IQR, 5) preoperatively to 5 (IQR, 5) postoperatively, p < 0.001. Patient satisfaction was median 1 (= very satisfied) (IQR, 1). Conclusion: A “slowly cutting, loose seton ligature followed by a staged fistulotomy”, heals the vast majority of perianal fistulas with minor or none influence on continence and few recurrences. Patient-reported HRQoL improves greatly, and patient satisfaction is high.
AB - Purpose: To investigate the ability of a “slowly cutting, loose seton ligature and staged fistulotomy” to heal perianal fistulas, the time needed with the seton ligature, recurrence rate, influence on anal continence, health-related quality of life (HRQoL), and patient satisfaction. Methods: Observational single-center study. We reviewed the medical records of all patients with primary surgeries from January 1, 2009, to December 31, 2018. The patients answered a questionnaire pre- and postoperative on anal continence (St. Mark’s incontinence score) and HRQoL (The Short Health Scale). Satisfaction with the operation was answered postoperatively. Results: Forty-three patients (37 men, 6 women) were included. Initially 41 of 43 healed (95%). Three patients (7%) had a recurrence, two healed after retreatment. The median follow-up was 55 months (IQR, 4). Thirty-four patients (79%) responded to the questionnaire. At follow-up, forty (93%) patients were healed. The median time treated with a seton ligature in the healed patients was 13 months (IQR, 14). St. Mark’s incontinence score preoperative was median 2 (IQR, 9) and after the operation median 1 (IQR, 4). The Short Health Scale improved from median 20 (IQR, 5) preoperatively to 5 (IQR, 5) postoperatively, p < 0.001. Patient satisfaction was median 1 (= very satisfied) (IQR, 1). Conclusion: A “slowly cutting, loose seton ligature followed by a staged fistulotomy”, heals the vast majority of perianal fistulas with minor or none influence on continence and few recurrences. Patient-reported HRQoL improves greatly, and patient satisfaction is high.
KW - Anal continence
KW - Health-related quality of life
KW - Loose seton
KW - Modified loose seton
KW - Perianal fistula
U2 - 10.1007/s00423-023-03005-0
DO - 10.1007/s00423-023-03005-0
M3 - Journal article
C2 - 37673848
AN - SCOPUS:85169998997
VL - 408
JO - Langenbecks Archives of Surgery
JF - Langenbecks Archives of Surgery
SN - 1435-2443
IS - 1
M1 - 352
ER -
ID: 370576570