Multi-center Study of Ksharasutra in the Management of High Anal Fistula-A Clinical Study

The disease, high anal fistula is a common ano-rectal disorder as old as mankind and usually results as a sequel to some varieties of ano-rectal abscesses and is a challenge to surgeons still today. Fistula-in-ano has been recognized as special distinct entity for thousands of years. In the fifth century B.C. Hippocrates advocated the laying open of fistulas, including complex fistulas. One would think that over 2,500 years the controversies in the management of fistula-in-ano would have been resolved. This is not the case, and much about the management of fistula-in-ano is still being debated. Available surgical procedures may not only result in incontinence but also recurrences. They cause discomfort and absence from work with consequent economic strain.

OBJECTIVES AND METHOD OF PREPARATION:Keeping all these problems in mind, Susturta’s (800B.C) Ksharasutra technique (a medicated alkaline thread impregnated with the pasted of Curcuma longa, alkaline substance of Achyranthesaspsera and latex of Euphorbia rerifolia is employed along the fistula track which cuts itself and heals the wound form inside with no complications.

PRIMARY RESULTS:Keeping all these problems in mind, a safe, simple and unique Ayurvedic surgical technique of Ksharasutra was employed in 45 patients of Hign anal fistulae with majority of them were reccured were taken up for this multi-center study under the supervision of different Surgeons and Physicians with a common proforma and case sheet.

CONCLUSION:This new approach in High anal fistulae with Ksharasutra is proved to be better than conventional fistulectomy technique with no recurrence and incontinence. Here with the above aim in mind a detailed documentation of visual aids and live recording of surgical procedure was also carried out subjecting the data for statistical validation.

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