Perianal Fistül Cerrahisinde Seton Tekniği: İki Farklı Seton Materyalinin Klinik Sonuçları

Year 2021, Volume: 26 Issue: 3, 287 - 295, 27.09.2021

Murat Yıldırım Hüseyin Bakır

https://doi.org/10.21673/anadoluklin.903232

Abstract

Amaç: Bu çalışmada iki farklı seton materyali kullanılarak ameliyat edilen perianal fistül (PF) hastalarında nüks, inkontinans ve tedavi başarı oranlarını karşılaştırmak amaçlanmıştır.
Yöntem: Ocak 2016—Mayıs 2020 döneminde bir tıp fakültesi hastanesinde PF tanısı alan ve seton yöntemi kullanılarak ameliyat edilen toplam 66 hastanın tıbbi verileri (fistül özellikleri, hastanede kalış ve takip süreleri, postoperatif komplikasyonlar, nüks ve inkontinans varlığı) retrospektif olarak incelendi. Hastalar, kullanılan (Prolene veya cerrahi eldivenlerden elde edilen elastik bant) seton materyaline göre iki gruba ayrıldı. İnkontinans değerlendirmesi için Jorge–Wexner inkontinans skorlama sistemi kullanıldı.
Bulgular: Hastaların 48’i (%72,7) erkek, 18’i (%27,3) kadındı. Yirmi altı hasta (%39,4) Prolene, 40 hasta (%60,6) elastik bant seton kullanılarak ameliyat edilmişti. Genel iyileşme oranı %93,9, nüks oranı %7,6, inkontinans oranı %6,1 idi. Prolene grubunda nüks ve inkontinans oranları daha yüksek olmasına rağmen iki grup arasında istatistiksel olarak anlamlı fark yoktu (sırasıyla p=0,074 ve p=0,292).
Sonuç: Cerrahi eldivenden elde edilen elastik materyal, geleneksel kesici seton materyalleri gibi düşük nüks ve kabul edilebilir inkontinans oranları ile PF cerrahisinde seton olarak kullanılabilir.

Keywords

Anal fistül, Elastik seton, İnkontinans

Supporting Institution

Hayır

The Seton Technique in Perianal Fistula Surgery: Clinical Outcomes of Two Different Types of Seton Material

Abstract

Aim: In this study we aimed to compare the recurrence, incontinence and treatment success rates in patients with perianal fistulas (PF) who were operated on using two different seton materials.
Methods: We retrospectively reviewed the medical records (PF characteristics, length of hospital stay and follow-up, postoperative complications, and presence of recurrence and incontinence) of a total of 66 patients who were diagnosed with PF and operated on using the seton method in a medical faculty hospital between January 2016 and May 2020. The patients were divided into two groups according to the seton material used (Prolene or elastic band material obtained from surgical gloves). Incontinence assessments were made using the Jorge–Wexner incontinence scoring system.
Results: Of the patients, 48 (72.7%) were male and 18 (27.3%) were female. Prolene and elastic seton materials were used in the surgery of 26 (39.4%) and 40 (60.6%) patients, respectively. The general recovery rate was 93.9%, recurrence rate was 7.6%, and incontinence rate was 6.1%. Although the recurrence and incontinence rates were higher in the Prolene group, there was no statistically significant difference between the two groups (p=0.074 and p=0.292, respectively).
Conclusion: Elastic material obtained from surgical gloves can be used as a seton in PF surgery, with low rates of recurrence and acceptable rates of incontinence similar to those with traditional cutting seton materials.

Keywords

Anal fistula, Elastic seton, Incontinence

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