Perianal fistulas and seton application procedure: is it really safe to use?

BACKGROUND: The aim of this study was to evaluate the outcomes of the patients underwent seton placement due to perianal fistula. METHODS: The result of patients diagnosed with perianal fistula and treated with seton method between January 2012 and January 2019 were examined. RESULTS: A total of 312 patients were included in the study. Of all patients, 64 were female and 248 were male. The rate of surgical intervention due to perianal fistula was 25.6%. The rate of seton revision was 12.8%. One seton was applied in 89.7% of the patients, two setons in 5.1% and three setons in 5.1% simultaneously. Partial fistulectomy was performed with seton placement in 64.1% of the patients. The mean duration of follow-up was 36 months in the female and 32 months in the male patients. The mean duration of seton prolapse was 3.96 months. The rate of recurrence was 12.8%, and the rate of incontinence was 7.7%. The rate of full recovery was determined as 80.0%. CONCLUSIONS: Although seton placement is a successful method in the treatment of perianal fistula, its complications are not as low as thought. One of the reasons of high complication rate was that seton application was preferred in complicated patients.