E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research

Online Publishing Date:
24 / 09 / 2017

 


Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed)

Rajneesh Kumar, Ankur Hastir.


Abstract
Objective: There are two main complications after surgery of complex fistula-in-ano: i.e. faecal incontinence and recurrence.
Summary Background Data: To prevent incontinence of stools and flatus we require saving the anal sphincter muscle with tightening of seton using Roeder’s knot with knot pusher (specially designed).
Method: The study includes 40 patients who had undergone treatment of complex and high fistula-in-ano at Civil Hospital, Jalandhar from January, 2010 to September 2012 and from September, 2012 to January, 2014 at Punjab Institute of Medical Sciences (PIMS).
Results: 40 patients of complex fistula-in-ano were taken up for study with the age (mean ± standard deviation) of 35 ± 10.6 years. The Roeder’s knot was tightened with a median of 5 times (3-10 times) as OPD procedure. All the patients were on follow up for minimum period of 6 months and none of the patient had any incontinence. Recurrence occurred in one case. There was breakage of thread at knot site with knot pusher in two cases.
Conclusion: Tightening of seton using Roeder’s knot is safe, cost effective treatment for complex fistula-in-ano and follow up is easy and tightening of fistula is an outdoor procedure rather than replacing the loose seton. Fistula-in-ano or recurrent fistula or fistula encircling more than 30% of external anal sphincter. Patients were on follow up every week and seton with Roeder’s knot tightened in O.P.D after application of 2% xylocain jelly. Incontinence was assessed according to wexner’s score.

Key words: Seton, Roeder’s knot, Knot Pusher, Fistula-in-ano, Tightening


 
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How to Cite this Article
Pubmed Style

Rajneesh Kumar, Ankur Hastir. Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). Int J Surg Med. 2017; 3(4): 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula


Web Style

Rajneesh Kumar, Ankur Hastir. Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). https://www.ejos.org/?mno=266624 [Access: February 19, 2024]. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula


AMA (American Medical Association) Style

Rajneesh Kumar, Ankur Hastir. Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). Int J Surg Med. 2017; 3(4): 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



Vancouver/ICMJE Style

Rajneesh Kumar, Ankur Hastir. Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). Int J Surg Med. (2017), [cited February 19, 2024]; 3(4): 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



Harvard Style

Rajneesh Kumar, Ankur Hastir (2017) Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). Int J Surg Med, 3 (4), 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



Turabian Style

Rajneesh Kumar, Ankur Hastir. 2017. Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). International Journal of Surgery and Medicine, 3 (4), 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



Chicago Style

Rajneesh Kumar, Ankur Hastir. "Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed)." International Journal of Surgery and Medicine 3 (2017), 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



MLA (The Modern Language Association) Style

Rajneesh Kumar, Ankur Hastir. "Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed)." International Journal of Surgery and Medicine 3.4 (2017), 223-227. Print. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula



APA (American Psychological Association) Style

Rajneesh Kumar, Ankur Hastir (2017) Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed). International Journal of Surgery and Medicine, 3 (4), 223-227. doi:10.5455/ijsm.Tightening-of-seton-Roeder-knot-complex-fistula