MANAGEMENT OF HIGH FISTULA IN ANO WITH CUTTING SETON

Background: Management of high fistula-in-ano is a surgical challenge. Fistulotomy cannot be done in such cases due to the risk of sphincter damage and subsequent fecal incontinence. The aim of this study was to determine the rate of faecal incontinence and recurrence in patients with high fistula-in-ano treated with polypropylene (prolene-1) as cutting seton. Material Methods: This was a descriptive cross-sections study of 30 consecutive patients of high fistula in ano treated with cutting seton at Mufti Mehmood Memorial Teaching Hospital, D.I.Khan from 1-4-2011 to 31-3- 2014. Follow-up was made for at least 6 months to record the fistula recurrence, anal incontinence and duration of complete wound healing. Results: The study involved 30 patients of mean age 40 years (range 20 to 66 years). Complete healing occurred in all the patients (100%) within 3 months. Recurrent fistula was noted in one (3.3%) patient at 5 months while none developed incontinence. Conclusion: Treatment of high fistula-in-ano with cutting seton is associated with low complication rate. It can therefore be recommended as the standard treatment for high fistula-in-ano