Evaluating the Efficacy of Cutting Setons for the Treatment of Anal Fistulas

Anal fistula is a common disease of the anal region that can be treated using a cutting seton. The objective of this study was to investigate healing and recurrence outcomes of anal fistulas treated via cutting setons performed by a specialist colorectal surgery group at a single academic institution. This retrospective chart review study included 143 patients who underwent a cutting seton procedure at a single academic institution to treat their anal fistula between January 2013 and December 2018. The main outcomes measured in this study were healing rates, recurrences rates, incontinence rates, and infectious complication rates of anal fistulas being treated with a cutting seton. In total, 127 (88.8%) patients’ fistulas healed after treatment with a cutting seton. Fifteen (10.5%) patients had a fistula recurrence after treatment. Fourteen (9.8%) patients experienced an infectious complication after the cutting seton procedure while 8 (5.6%) patients developed some form of incontinence during the fistula healing period. Average healing time for fistulas after cutting seton treatment was 1.9 months (7–8 weeks). This study indicates that the cutting seton procedure is an effective and safe method for treating anal fistulas. Cutting setons lead to low rates of complications (like infections and incontinence) and good long-term outcomes when it comes to maintaining anal sphincter function after presence of a complicated and/or high anal fistula. This study suggests that the cutting seton remains an alternative to other procedures, which maybe more invasive and compromising.