Assessing quality of life in anal fistula patients after Seton placement using different knot types: Randomized controlled trial

PURPOSE: Perianal fistula is a common disease that significantly affects the quality of life of patients. Several treatment options are available; loose seton is one of the most popular options. Aim of this study was to evaluate the relationships between quality of life and different types of knots used during the application of anal fistula. METHODS: Patients who presented with anal fistulas between 2021 and 2024 were included in this study. Patients were divided into 3 groups on the basis of the type of knot used for treatment. In group A, the seton ends were tied in the alpha configuration. In group B, a ring-like seton with overlapping ends was used. In group C, a knotless seton was applied. All patients completed the quality of life assessment with the Anal Fistula Questionnaire at 15, 30, and 90 days after surgery. RESULTS: Sixty-three patients were randomized. A total of 52 men were included. Median age was 43 years. Three patients in group C and five patients in group B experienced complications, including abscess, anal pain, loss of seton, and second fistula. Physical and mental component scores revealed that postoperative quality of life was similar among the three groups. CONCLUSION: No differences in postoperative quality of life among groups were observed at 15, 30, or 90 days after surgery. Physical and mental component scores of quality of life in patients in Anal Fistula Questionnaire revealed that quality of life improved over time in all three groups. CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (Study ID: NCT05348473, date: 04/29/2022).