INNOVATIVE MANAGEMENT OF ANAL FISTULA: PARTIAL FISTULECTOMY WITH KSHARSUTRA (HIGH ANAL / HORSE SHOE FISTULA)

Aim and Objective- Anal fistula is a condition which has been recognized as a difficult surgical disease in all the ancient [1] and modern medical sciences of the world. The approach to the treatment for a single disease is only suggestive of the fact that none of these methods is satisfactory. 'Ksharsutra' is being used successfully in the management of anal fistula [2], but in the case of High Anal / Horse Shoe Fistula particularly it is not convenient as size of wound is big which increases duration of therapy and hospitalization and ultimately on cost of therapy. To overcome all these problems, partial fistulectomy with 'Ksharsutra' is the ray of Hope. Material and Methods- Patients are recruited from Shalyatantra OPD after confirmed diagnosis. Ethical guidelines of ICMR for human research were strictly followed. Results and Discussion- All Patients were diagnosed, investigated and after physical fitness under spinal anesthesia, Partial Fistulectomy with 'Ksharsutra' was carried out. 'Ksharsutra' was changed on weekly basis & patients were observed for parameters during this weekly follow-up for 12 weeks. All observations were recorded in the Case record Form. All study data was analyzed by applying Students Paired‘t’ test and significance 'P' value calculated for individual symptoms. Conclusion- High anal fistula with partial fistulectomy 'Ksharsutra' is an ideal treatment because recovery of disease is fast & none of expected complication like incontinence of sphincter control, fecal soiling, rectal prolapse were found & recurrence rate is only 3-4%. So this therapy is effective, has less complications with minimal récurrence rate