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

Besendörfer M, Langer L, Carbon R, Weiss C, Müller H, Diez S (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Frontiers in Surgery Frontiers Media

Book Volume: 10

Article Number: 1144425

DOI: 10.3389/fsurg.2023.1144425

Abstract

Background: Therapeutic 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 methods: We 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). Results: Treatment 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. Conclusions: Non-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.

Authors with CRIS profile

Manuel Besendörfer Department of Paediatric Surgery Laurin Langer Department of Surgery Sonja Diez Department of Paediatric Surgery

Additional Organisation(s)

FAU Profilzentrum Licht.Materie.Quantentechnologien (FAU LMQ)

Related research project(s)

Fistula-in-ano in Infants and Children Jan. 1, 2023 - Dec. 31, 2027

Involved external institutions

Universitätsklinikum Mannheim DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE)

How to cite

APA:

Besendörfer, M., Langer, L., Carbon, R., Weiss, C., Müller, H., & Diez, S. (2023). Treatment of pediatric fistula-in-ano—Sphincter-sparing non-cutting seton placement as the future treatment of choice? Frontiers in Surgery, 10. https://doi.org/10.3389/fsurg.2023.1144425

MLA:

Besendörfer, Manuel, et al. "Treatment of pediatric fistula-in-ano—Sphincter-sparing non-cutting seton placement as the future treatment of choice?" Frontiers in Surgery 10 (2023).

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