Effectiveness of Seton In Anal Fistula

Fazal Ghani, Kamran Hakeem Khan, Mudasar Shahzad, Kamran Ahmad

  • Kamran Hakeem Khan Department of General Surgery Qazi Hussain Ahmed Medical Complex, Nowshera



To determine the healing and recurrence rates of anal fistula with seton and affect of cormorbid conditions on these variables.

Study design

Cross sectional study.

Place & Duration of study

Department of Surgery, Qazi Hussain Ahmed Medical Complex Nowshera, From June 2018 to November 2018.


Sample size of 110 anal fistula patients was calculated using WHO calculator. Non probability consecutive sampling was used. Ethical approval and consents were obtained. All patients underwent anal fistula surgical procedure with seton. Effectiveness of seton was determined by finding recurrence and healing rates. Effect of co morbids like diabetes mellitus (DM), hypertension and cardiovascular disease was also determined. SPSS software was used for data analysis. Chi-square test was applied and p value <0.05 was considered significant.


A total 110 anal fistula patients were included in this study. There were 80 (72.7%) male and 30 (27.3%) female patients.  Mean age of study subjects was 41.1±1 year. Healing rate was =50% in 32 (29.1%) and >50% in 78 (70.9%). Recurrence rate was =10% in 88 (80%) and >10% in 22 (20%) patients. Healing rate was >50% in majority of diabetes mellitus patients (p=0.05), hypertensive patients (p=0.05) and low in cardiovascular disease patients (p=0.34). Majority of patients with seton who had low pain score had healing rate >50% (p=0.01). Recurrence rate was significantly associated with DM (p=0.001) and hypertension (p=0.000). Healing rate and recurrence rate were insignificantly associated with age (p=0.648, p=0.792)and gender (p=0.243, p=1.00) respectively.


Seton was an effective and safe mode of management of anal fistula with relatively high success and low recurrence rate.

Key words

Seton, Anal fistula, Recurrence.