Background: Fistula-in-ano is a persistent pathological connection, lined with unhealthy granulation tissue, extending from the ano-rectum to the peri-anal skin, manifesting as an external orifice on the perineum or buttock. It is thought to originate from crypto-glandular factors, with the fistulous tract typically resulting from compromised drainage of anal glands. It frequently results in pain, edema, discharge, pruritus, and social shame. Setons have been utilized for the management of fistula-in-ano for centuries, primarily for high or difficult anal fistulas to prevent fecal incontinence and recurrence. Conversely, the widely recognized Kshara-sutra therapy is accessible for Bhagandara, exhibiting a minimal recurrence rate of 3.33%.
Aims and Objectives: To assess and compare the effectiveness of seton and kshar-sutra procedures in treatment of fistula in ano in a tertiary hospital
Materials and Methods: A randomized controlled study including 30 patients with anal fistula was conducted by the Department of General Surgery at Bhaskar Medical College for a duration of 18 months. Approval was obtained from the Institutional Ethical Committee prior to initiating the project.
Results: The demographic and clinical parameters were comparable between the groups., Kshar group had significantly lesser operating time [P=<0>, with lesser degree of pain [P<0> in the post operative period. The hospital stay [P=<0>, no. of days absent from work [P=<0>, and healing time [P<0> was also significantly lesser in Kshar Group.
Conclusion: Kshar-sutra procedures were significantly more effective that seton in treatment of fistula in ano.
Keywords: Fistula in ano, Seton, Kshar-sutra
