Outcomes of Draining Seton Insertion followed by Ligation of the Intersphincteric Fistula Tract Versus Cutting Seton Insertion for Anal Fistula: A 5-Year Retrospective Cohort Study

Abstract

BACKGROUND: 

This study aimed to compare healing time, recurrence rates, incidence of incontinence, and quality of life between the Ligation of the Intersphincteric Fistula Tract (LIFT) procedure (preceded by draining seton insertion) and cutting seton insertion for anal fistula over a 5-year period.

METHODS: 

A retrospective cohort study was conducted on patients with high-type perianal fistulas who underwent either LIFT (preceded by draining seton insertion) or cutting seton insertion between May 16, 2018, and April 17, 2024, at Shahid Faghihi and Ghadir Mother and Child Hospitals. A comparative analysis was performed to evaluate healing time, recurrence rates, incidence of incontinence, and quality of life between the two surgical approaches.

RESULTS: 

The study included 51 patients who underwent LIFT surgery and 48 who received cutting seton insertion. There were no significant differences between the two groups in terms of demographic characteristics or behavioral factors. Additionally, no statistically significant differences were observed between the two groups regarding fecal incontinence, healing rates, recurrence, healing time, and quality of life (P>0.05). However, patients who underwent cutting seton insertion exhibited a non-significant lower recurrence rate compared with those who received the LIFT procedure (8.3% vs. 17.6%).

CONCLUSION: 

This study provides valuable insights into the comparison of the efficacy of cutting seton insertion versus the LIFT procedure for managing anal fistulas. By evaluating key postoperative outcomes, the findings may help in clinical decision-making and enhance patient care strategies in colorectal surgery.