Treatment of pediatric fistula-in-ano - Sphincter-sparing non-cutting seton placement as the future treatment of choice?

• Verfasst von: Besendörfer, Manuel [VerfasserIn]
• Verfasst von: Langer, Laurin [VerfasserIn]
• Verfasst von: Carbon, Roman [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Müller, Hannah [VerfasserIn]
• Verfasst von: Diez, Sonja [VerfasserIn]
• Titel: Treatment of pediatric fistula-in-ano - Sphincter-sparing non-cutting seton placement as the future treatment of choice?
• Verf.angabe: Manuel Besendörfer, Laurin Langer, Roman Carbon, Christel Weiss, Hanna Müller and Sonja Diez
• E-Jahr: 2023
• Jahr: 11 April 2023
• Umfang: 6 S.
• Fussnoten: Gesehen am 13.06.2023
• Titel Quelle: Enthalten in: Frontiers in Surgery
• Ort Quelle: Lausanne : Frontiers Media, 2014
• Jahr Quelle: 2023
• Band/Heft Quelle: 10(2023) vom: Apr., Artikel-ID 1144425, Seite 1-6
• ISSN Quelle: 2296-875X
• DOI: doi:10.3389/fsurg.2023.1144425
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1848857195

Abstract

BackgroundTherapeutic principles of fistula-in-ano (FIA) are lacking evidence-based consensus on treatment options. Non-cutting, sphincter-sparing options have not been published for infancy and childhood FIA.Patients and methodsWe are presenting retrospective data on FIA treatment with non-cutting seton placement between 2011 and 2020. Data were collected based on medical records and complemented by patients’ contact for follow-up analyses between November 2021 and October 2022. Data were analyzed regarding the outcome variables of recurrent FIA and recurrent perianal abscess. Furthermore, outcomes in different age groups were compared (<1/1.5-12 years of age).ResultsTreatment duration with non-cutting seton was at a median of 4.6 months and was not associated with recurrent FIA (p = 0.8893). Overall recurrence rate of FIA within an observation time of 9 months postsurgically was at 7% (n = 3/42) and was only seen in infancy, whereas recurrent perianal abscess was mainly observable in children (n = 2, p = 0.2132). Comparison of age groups revealed no significant differences. Of the 42 included patients, 37 responded in the follow-up analysis, resulting in a response rate of 88% with a median follow-up time of 4.9 years. Fecal incontinence was postsurgically only seen in two patients, who were diagnosed prior to surgery and symptoms remained unchanged.ConclusionsNon-cutting seton placement might be a promising option in the treatment of FIA in infancy and childhood. Perioperative settings like duration of placed seton and antibiotic treatment have to be discussed in further prospective, enlarged population-based studies.