Abstract:Objective Despite all the technological advances, successful management of complex fistula-in-ano is still a challenge due to recurrence and incontinence. The present study evaluates the outcomes of a novel technique, Interception of Fistula Track with Application of Ksharasutra (IFTAK) in terms of success rate and degree of incontinence.
Methods In the present prospective study, 300 patients with complex fistula-in-ano were treated by the IFTAK technique, whose surgical steps include: incision at th… Show more
“…In IFTAK, treatment duration is relatively short, there is little or no hospital stay, and significantly less tissue is injured during surgery., Further, it can be performed under local anesthesia and leaves only a minimal scar at the operative site. IFTAK reduces the duration of treatment by shortening the track and focusing on eradicating of infected anal crypt which is the principal site of pathology in anal fistula[ 11 ]. As a result, no treatment of the distal or residual track is required.…”
“…In IFTAK, treatment duration is relatively short, there is little or no hospital stay, and significantly less tissue is injured during surgery., Further, it can be performed under local anesthesia and leaves only a minimal scar at the operative site. IFTAK reduces the duration of treatment by shortening the track and focusing on eradicating of infected anal crypt which is the principal site of pathology in anal fistula[ 11 ]. As a result, no treatment of the distal or residual track is required.…”
The management of complex anal fistulae is a challenging job because of the possible risk of damage to the anal sphincter leading to fecal continence, high reoccurrence rate, and delayed wound healing. Other challenges include proper drainage of the tract without disturbing anatomical alignment and painless defecation. This case presented to the outpatient department with a history of recurrent boil in the perianal region and painful pus discharge from the site for 15 days. The case was diagnosed as a case of complex fistula-in-ano and was managed by an integrative approach operative procedure under spinal saddle block anesthesia. Principles of application of Interception of Fistulous Tract and Application of Ksharasutra (IFTAK), transanal opening of intersphincteric space, and tube in tract technique were applied in the management. With necessary analgesia and antibiotics for five days, the patient was given Triphala guggulu internally, and sitz bath with Haritaki (Terminalia chebula Retz.) and Neem (Azadirachta indica A. Juss.) decoction, postoperatively. Wound dressing was done by application of a gauze piece soaked in Apamarga kshara taila. The management resulted in a painless recovery and the patient started attending his daily routine activities from the 7th post-operative day onwards. Pus discharge ceased soon after the operative procedure. Complete healing of postoperative wounds was achieved in ten weeks with prescribed postoperative care and regimen. For the last year, the patient is free from anal discomfort and no reoccurrence has been reported till now.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.