NCT03636997

Treatment of Complex Anal Fistula With Draining Seton With or Without Rerouting of Track

Treatment of Complex Anal Fistula With Draining Seton With or Without Rerouting of the Fistula Track: a Randomized Controlled Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 60 (actual)
• Sponsor: Mansoura University · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

This randomized trial aimed to compare conventional draining seton with or without rerouting of the fistula track in treatment of complex anal fistula

Detailed description

Placement of seton is typically employed when the fistula track is involving more than 30% of the external anal sphincter. However, attempts to reroute the seton and the involved fistula track were made to preserve the external anal sphincter fibers and hasten healing of the anal wound. Mann and Clifton first introduced a transposition technique for the management of high anal and anorectal fistulas by re-routing the extrasphincteric portion of the track into an intersphincteric position with immediate repair of the external sphincter and reported successful outcomes of five patients in terms of quick healing and preserved anal continence. The present study aimed to evaluate the outcome of draining seton with or without rerouting of the fistula track in treatment complex high anal fistula regarding healing time, postoperative pain, and incidence of recurrence and FI postoperatively. We hypothesized that rerouting the seton to include the fistula track and the internal anal sphincter only, preserving the external anal sphincter muscles, would serve to hasten healing and decrease the incidence of recurrence and continence disturbances.

Conditions

• Anal Fistula

Interventions

Type	Name	Description
PROCEDURE	Draining seton	Number 1 silk suture was passed through the fistula track and tied as loose seton
PROCEDURE	Rerouting of track	The seton and fistula track were rerouted to involve the internal anal sphicnter only and spare the external sphincter

Timeline

• Start date: 2017-02-01
• Primary completion: 2018-02-28
• Completion: 2018-07-30
• First posted: 2018-08-17
• Last updated: 2018-08-17

Locations

1 site across 1 country: Egypt