Academic literature on the topic 'Ksharsutra'

<strong>Background:</strong>&nbsp;Fistula in ano presents a significant clinical challenge due to its recurrent nature and impact on quality of life. Traditional surgical treatments include fistulectomy and less invasive procedures such as the Ksharsutra technique, but recurrence and postoperative complications remain concerns.&nbsp;<strong>Objective:</strong>&nbsp;This study aims to evaluate and compare the efficacy, safety, and patient satisfaction of three surgical techniques for treating fistula in ano: fistulectomy, Ksharsutra, and LIFT (ligation of intersphincteric fistulous tract).&nbsp;<strong>Method:</strong>&nbsp;Ninety patients diagnosed with fistula in ano were randomized into three groups: Group A (fistulectomy), Group B (LIFT), and Group C (Ksharsutra). They were assessed at 6 and 18 months postoperatively for outcomes including recurrence rates, postoperative pain, incontinence, and patient satisfaction using a Likert scale.&nbsp;<strong>Results:</strong>&nbsp;The LIFT procedure (Group B) demonstrated superior outcomes across all measured parameters. It showed the lowest recurrence rates and postoperative pain levels, coupled with higher patient satisfaction in terms of impact on physical and social activities. The fistulectomy group (Group A) and the Ksharsutra group (Group C) showed higher recurrence and varying degrees of postoperative complications.&nbsp;<strong>Conclusion:</strong>&nbsp;The LIFT procedure offers a significant advantage over fistulectomy and Ksharsutra in the treatment of fistula in ano, providing better clinical outcomes with fewer complications and enhanced patient satisfaction. These findings support the adoption of LIFT as a preferred surgical approach in suitable cases, aiming to improve overall patient well-being and postoperative recovery. &nbsp; &nbsp;

Management of fistula is one the most notorious job for the surgeon because of its ill site, chronicity, and recurrences. Treatment modalities like anal fistula plug, mucosal flap advancement, fibrin glue, and VAAFT (Video Assisted Anal Fistula Treatment) are there but ksharsutra has edge on them for its success rate and non-recurrence. Even after its better results, weekly sitting and pain during changing of ksharsutra and discomfort of ksharsutra being in situ makes it difficult for patient to pursue the treatment. Hence, a new approach was mandatory. Considering fistula to be a dushtavrana, shashti upakrama like lekhan, shodhan and ropan were applied in a patient of high-anal transphincteric fistula. Partial fistulectomy, excessive curettage (lekhan) from its internal opening was done. Internal opening was closed and wound was allowed to heal by second intension with the help of shodhan and ropan tail. Post-operative antibiotics and anti-inflammatory were given. It was observed that wound healed at good rate without discomfort of patient in 25 days. It underlines importance of shashtiupkrama in modern age of surgery also.

There are several anorectal disorders facing by large number of population with diverse group of pathologic conditions. Among them anorectal disorders like Arsha (haemorrhoids), Parikartika (fissure) and Bhagandar (fistulas) are among the most common anorectal conditions. These conditions are the cause of significant discomfort and disability to the patient and can impair a person’s quality of life. Ayurveda is playing important role and contributing to modern technology with its own originality with authenticity. Advantage of Ksharsutra therapy in the management of Arsha is that it is a minimally invasive surgical procedure and can be performed under local anaesthesia and have good results in wound healing. In the presented study, Ksharsutra ligation was performed on a patient aged 23 years suffering from Arsha on 3 ‘o’ clock position prolapsed without bleeding but with irritation, pruritis ani and mild mucous discharge. Ksharsutra has been found to be effective, economic, easy to prepare and use. Moreover the daily routine of the patient is not disturbed. As this study performed on a single patient, more such trials are required to reach concrete conclusions.