Dr. Sadaf Zafarullah, Dr. Naila Bajwa
Aim: To evaluate the effectiveness of cutting seton in the treatment of high anal fistulas. Design and duration: A quasi-experimental study was held in the Surgical Unit-II Jinnah Hospital Lahore for one-year duration from March 2019 to March 2020. Methodology: All cases with high anal fistula were selected for study. After clinical examination, all patients with high anal fistula were treated with cutting seton; the material was metal wire. The probe was inserted through the outer opening and the channel on the grooved probe was opened up to the toothed line, then inserted through the seated outer opening and out of the anus through the inner opening and tied at the anal edge. Every two weeks the seton was tightened until it crossed the road. Results: Of all 25 patients, 20 (80%) were male and 5 (20%) were female. Their ages ranged from 20 to 60, and the average age was 38. The duration of symptoms ranged from 3 to 24 months. The main ailments were perianal discharge, rectal swelling, pain and premonition. The fistula healed completely in 21 (84%) patients; 3 (12%) of patients experienced some degree of bloating urinary incontinence, but none with feces. One patient had a recurrence of the fistula. Conclusion: The treatment of a high anal fistula by staged fistulotomy with a cutting seton is very satisfactory, with minimal postoperative complications. KEYWORDS: high anal fistula, stage fistulotomy, seton, metal wire.