External sphincter-sparing anal fistulotomy (ESSAF): a simplified technique for the treatment of fistula-in-ano

2021 ◽  
Author(s):  
S. Y. Parnasa ◽  
B. Helou ◽  
I. Mizrahi ◽  
R. Gefen ◽  
M. Abu-Gazala ◽  
...  
Keyword(s):  
External Sphincter ◽  
Fistula In Ano

scholarly journals Kharsutra Ligation with Partial Fistulectomy-As a Treatment for Anterior Trans-Sphincteric Fistula in Ano- A Case Study

2019 ◽  
Vol 7 (1) ◽  
pp. 46-49
Author(s):  
Soham Patel ◽  
Neha Thumar ◽  
Rajesh Sharma ◽  
Harshit Shah
Keyword(s):  
Surgical Treatment ◽  
External Sphincter ◽  
Fecal Continence ◽  
High Rate ◽  
Perianal Region ◽  
Sphincter Injury ◽  
Perianal Fistulas ◽  
Fistula In Ano ◽  
Cutting Seton

Perianal fistulas are prevalent in 0.01- 0.05% of the population and are commonly associated with discomfort and morbidity to the patient. Surgical treatment is the only modality of management of fistulas with the pitfall of high rate of recurrence In Transsphincteric fistulas, the track passes from the inter sphincteric space through the external sphincter into the Perianal region. Surgical treatment of perianal fistulas frequently affects fecal continence. Sphincter saving techniques like Ksharsutra (cutting seton) and fistulectomy has been advocated to minimize the risk of sphincter injury.

Managament of Bhagandara (Fistula-in-Ano) by Palasha Ksharasutra prepared with Arkaksheera - A Case Report.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Success Rate ◽  
Spinal Anesthesia ◽  
Curcuma Longa ◽  
Weekly Interval ◽  
Butea Monosperma ◽  
Fistula In Ano

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.

Effecacy of Kadali Kshara Sutra in the Management of Bhagandara (Fistula-In-Ano) - A Case Report

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Shilpa Patil ◽  
Ashok Naikar ◽  
Chandrakanth Halli
Keyword(s):  
Case Report ◽  
Mode Of Action ◽  
World Wide ◽  
Single Plant ◽  
Anal Region ◽  
Fistula In Ano ◽  
Highly Effective

Bhagandara (Fistula in ano) is a common anorectal condition prevalent world wide, and its prevalence is second highest after Arshas (Haemorrhoids). Kshara Karma is a one of the parasurgical procedure in Ayurveda. In this study Palasha Kshara Sutra is used in Bhagandara (Fistula-in-ano). Though, Apamarga Kshara Sutra is highly effective in the management of Fistula-in-ano. But pain, irritation, difficulty in preparation has limited its use. Thus, various type of Kshara Sutra tried with their efficacy in different angle. In this present study effort will be made to define the probable mode of action of Palasha Kshara Sutra prepared in Arka Ksheera in Fistula-in-Ano. This is equally effective with less pain and easy to prepare because a single plant is enough and not a seasonal plant. A 56 yr old male presented with complaints of painful swelling with pus discharge in the anal region since 1 week has been presented here.

scholarly journals The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Carlos Placer-Galán ◽  
Jose Mª Enriquez-Navascués ◽  
Tania Pastor-Bonel ◽  
Ignacio Aguirre-Allende ◽  
Yolanda Saralegui-Ansorena
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Cochrane Library ◽  
Fistula In Ano ◽  
Intersphincteric Fistula ◽  
The Impact ◽  
Seton Placement ◽  
Primary Healing

Abstract Background There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design systematic review and meta-analysis. Data Sources A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results Ten studies met the criteria for systematic review, all retrospective, with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73–1.43: p = 0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27–42.7%), recurrence with the use of seton was 40% (IQR 26.6–51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3–51.3%) Limitations The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement.International prospective register of systematic reviews—PROSPERO registration number: CDR42020149173.

The Management of Fistula-in-Ano

2013 ◽  
Vol 56 (1) ◽  
pp. e1 ◽  
Author(s):  
James M. O’Riordan ◽  
Nancy N. Baxter
Keyword(s):  
Fistula In Ano
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