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Background: Complex fistula in ano poses challenges in treatment, often requiring procedures like partial fistulotomy followed by application of a cutting seton to prevent fecal incontinence and recurrence. Objective: This study aimed to assess the clinical outcomes of employing a modified cutting seton following partial fistulotomy for treating complex fistula in ano in a tertiary hospital setting. Method: A longitudinal study was conducted involving (n=57) patients admitted to the Department of Surgery, Rajshahi Medical College Hospital, over a 12-month period from May 2022 to April 2023. Purposive sampling was utilized, with patient data collected from medical histories, physical examinations, investigations, treatment sheets, and postoperative follow-ups using semi-structured questionnaires. Results: The study comprised predominantly male patients (78.94%), with the majority falling within the 35-45 age group (54.38%). Notable findings included a significant proportion with a history of perianal abscess (24.56%), with many having sought treatment from non-medical sources (71.42%). Recurrence rates at 3- and 6-months post-procedure were low (1.75% and 7.02% respectively), with minimal incidences of incontinence (7.01% at 3 months, 3.5% at 6 months). Conclusion: The study underscores the efficacy of partial fistulotomy and application of modified cutting seton procedure in managing complex fistula in ano, demonstrating minimal side effects in the clinical context. Surgeons are encouraged to consider this approach for better patient outcomes.
Nahid et al. (Tue,) studied this question.