Medium- to long-term outcomes of seton placement for fistula-in-ano in children: the experience of 103 patients from a single institution

Purpose: The aim of this study was to evaluate the efficacy of seton placement for anal fistula in children.

Methods: The clinical data of children with anal fistula treated by seton placement admitted from January 2017 to September 2022 were retrospectively analyzed. Our primary treatments for perianal abscess (PA) are conservative treatment and drainage. Patients with systemic and inflammatory bowel diseases were excluded.

Results: The median follow-up time of these patients was 23 (6-58) months, and the median onset age was 16 (3-156) months. Among the 103 patients, 75 with a single fistula and 20 with a double fistula were treated by primary seton placement. Seven patients with multiple fistulas were treated using staged seton placement, and one case using primary seton placement. A total of 97 patients experienced good healing, four patients experienced poor healing and healed after dressing change and debridement, and two patients with multiple fistulas who experienced recurrence underwent a second seton placement. The average healing time was four (1-10) weeks.

Conclusion: The medium- to long-term outcome of seton placement indicates that this procedure is safe and effective in the treatment of anal fistula in children.