Abstract
BACKGROUND
Cutting seton is still one of the main methods for the treatment of high complex anal fistula at present. During the treatment, the thread should be tightened many times until it falls off. The traditional thread tightening method is not only complicated in operation and painful for patients, but also requires specialized equipment and doctors to operate, which is very inconvenient. The above problems can be solved by self-adjusting seton.
AIM
To explore the clinical feasibility of self-adjustable seton in the treatment of high complex anal fistula.
METHODS
Sixty-one patients with anal fistula who met the inclusion criteria at the Department of Anorectal Surgery of Yuyao People's Hospital from July 2019 to June 2022 were selected and randomly divided into an experimental group (n = 29) with self-adjustable seton and a control group (n = 32) with traditional cutting seton (tightening the seton by stages). There was no significant difference between the two groups in terms of age, gender, body mass index, educational level, or the nature of disease (P > 0.05). The main pipe of the anal fistula was all treated with cutting and seton, but the postoperative tightening methods were different: A self-adjustable seton was used in the experimental group, while a traditional cutting seton in the control group. Tightening-falling off time, total tightening times, outpatient tightening times, the degree of tightening-related pain, wound healing time, and efficacy were compared between the two groups.
RESULTS
One patient in the experimental group and two in the control group were intraoperatively treated with drainage and seton, which was removed after surgery. There was no significant difference between the experimental group and the control group in terms of the time of thread tightening off, total thread tightening times, wound healing time, or efficacy (P > 0.05). Outpatient tightening times were less, and the average degree of tightening-related pain was lower in the experimental group than in the control group (P < 0.001).
CONCLUSION
Self-adjustable seton can achieve the effect of traditional cutting seton in tightening-falling off time, wound healing time, and efficacy. However, it is more convenient than traditional seton tightening, and can be adjusted at home to reduce outpatient tightening times, with less cutting pain and lower medical costs. Therefore, it is a relatively suitable tightening method at present and can be popularized and applied in the medical service community and other grass-roots hospitals as a suitable technology in the future.
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