Abstract

CLINICAL TRIAL OF KSHARSUTRA IN THE MANAGEMENT OF FISTULA IN ANO

Dr. Deodatta Bhadlikar, Dr. Devyani Bhadlikar, Dr. Shruti Saxena*, Dr. Archana Pandey Jumle, Rahul Jumle

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Abstract

Fistula in ano is an age old, common condition prevalent all over the world. Considered second to haemorrhoids in importance amongst all anorectal conditions, its prevalence in study was reported to be 10 percent of patients and 4 perecnt of all new outpatients. A retrospective study from India reported anal fistula to constitute 1.6 percent of all surgical admission. Though a benign condition, fistula in ano leads to major physical, psychological and social problems due to the persistent discharge through the external opening. Most of the fistules develop after rupture of adequate drainage of pyogenic anorectal abseesses which develop secondary to infection of the cryptic gland. Surgical treatment demands familiarity of the surgeon with the anatomy of the anorectal region and also with the pathogenesis of fistula in ano. The treatment usually comprises laying open or completely excising the fistulous track and then allow healing by secondary intention. This procedure requires hospitalisation and regular post operative dressing which is often painful. Complete healing takes from a few weeks to months. The chances of recurrence (0.7 to 26.5%) and incidence of anal incontinence (5 to 40%) being rather high.

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