CASE STUDY OF KSHARSUTRA LIGATION WITH PARTIAL FISTULECTOMY IN THE MANAGEMENT OF ANTERIOR TRANS-SPHINCTERIC FISTULA IN ANO – BHANAGDARA
Keywords:Trans Sphincteric Fistula, Bhagandara, Partial Fistulectomy, Kshar-Sutra Ligation, Sphincter Saving Procedure
Introduction : Perianal fistulas are prevalent in 0.01- 0.05% of the population and are commonly associated with morbidity to the patient. Surgical treatment of fistulas frequently affects fecal continence so Sphincter saving techniques like Kshar-sutra and partial fistulectomy has been advocated to minimize risk of sphincter injury. Ideal surgical treatment for anal fistula should aim to promote healing of the tract, whilst preserving the sphincters and mechanism of continence. Hence partial fistulectomy with kshar-sutra ligation accepted in patient with anterior trans- sphincteric fistula
Material & Method: 32 Years male patient having anterior trans sphincteric fistula treated with partial fistulectomy with kshar sutra ligation.Total 4 sitting of kshar sutra therapy done.
Result: After 4 sitting of kshar-sutra therapy fistula track completely cut and patient was completely cured.
Discussion: Anal fistula plug is safe but modestly effective in long-term follow-up, with low success rates. Fibrin glue showed poor healing rate. FiLaC and VAAFT procedure are expensive and high recuurence rate. For the complex fistula surgical options such as partial fistulectomy and kshar sutra ligation seem to be relatively safe.
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