Integrated procedure with Partial-fistulectomy and Ksharasutra application in the management of complicated fistula-Clinical video

Abstract

Ksharasutra (Para surgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara (fistula in ano), and generally difficult to treat. Bhagandara (Fistula-in-ano) is treated by different modalities in modern science, but till today no single modality has proved to be complete cure for Bhagandara (Fistula-in-ano). Not only complete cure, but serious post-operative complications like faecal incontinence, high recurrence rate. An appropriate answer for the management is a unique specialized para surgical procedure ksharasutra therapy which is well accepted and WHO approved. A case of 30-year male patient visited having complaints of swelling in left perianal and pus discharging sinus near anus since last one and half years. He was diagnosed as complicated fistula-in ano with two openings. Under spinal anaesthesia partial fistulectomy with ksharasutra ligation was done and post- operative daily sitz bath with Panchavalkala kwatha twice a day advice, daily dressing was done with jatyadi oil and apamarga kshara sutra changed every week.  After 6 weeks, cut through of the track patient was followed up after 1 year. No sign and symptoms of recurrence were observed.