Types of the Fistula
Treatment of Fistula
Operative results of anal fistula
Kshar Sutra Treatment of Fistula in Ano
After complete clinical and pathalogical investigations the patient is placed on operation table in lithotomy position. A malleable silver probe threaded with Kshar Sutra in its eye is passed into fistulous tract and index finger of second hand is inserted into anal canal. With the tip of probe and index finger in anal canal internal opening of the fistula is negotiated and terminal and of the probe is brought out of anal orifice with the help of index finger. Thus the probe is removed leaving the Kshar Sutra into fistulous tract. With the two ends of thread, a strong knot is applied outside the Anus. Dry guage is placed at anal region and bandage is applied.
Post operative care
Hot sitz bath twice daily after defaecation, mild aperient at night, and jatyad tail enema before defaecation is recommended. The Kshar Sutra is changed at weekly interval till whole fistulous tract is cut through, leaving a small wound which heals up withing 10-20 days.
Post operative Kshar Sutra treatment of fistula in Ano was reviewed for 3-5 years. The clinical data of 1739 cases were analysed. The cure rate of Anal fistula was 98.4% with nominal recurrence of 1.6% only. Imparement of rectal continence was not seen in any patient as it is common complication of surgery specially in high anal fistula.