• editor@ijmra.in
  • ISSN[Online] : 2643-9875  ||  ISSN[Print] : 2643-9840

VOLUME 06 ISSUE 08 AUGUST 2023

Revolutionizing Fistula Treatment: A Case Series on the Application of Kshara Sutra Therapy
1Aliaa A. Abdulqadir, M.B.Ch.B, MS, 2MDP RAJU, MD in Ayurveda (Shalya), 3Mukul H Patel, M.D.,FAMS
1Basra health directorate, Basra- Iraq 61014, University of sousse, faculty of medicine of souse,department of general surgery, Tunisia
2Chief proctologist & CEO, Hitam Ayurvedic Anorectal Institute,Akms Bujibabu Plaza, Nizampet X Roads,Hyaderababd-India 500085
3Department of proctology, Shreyas Anorectal hospital and research centre, Surat Gujarat India 395001 vice- chancellor, Gujarat ayurved university,Jamnagar-India 361008
DOI : https://doi.org/10.47191/ijmra/v6-i8-39

Google Scholar Download Pdf
ABSTRACT:

A chronic, abnormal contact between the epithelialized anal canal surface and the perianal skin is known as an anal fistula (fistula-in-ano), which can cause serious morbidity and lower quality of life. Traditional surgical procedures as well as more contemporary ones, like the application of fibrin glue, a plug, or closure of the intersphincteric fistula tract, are available as treatment options (LIFT). These conventional techniques, however, may have varying degrees of efficacy, and some may be connected to the risk of incontinence. The Kshara Sutra, an antiquated Ayurvedic parasurgical procedure, was used to treat a case series of 10 patients with a range of anal fistulas, ranging in complexity from simple to complex presentations. Patients in the cases range in age from 22 to 55, both male and female. Despite variations in their particular circumstances, all patients had completely healed fistulas following Kshara Sutra treatment. Additionally, this treatment showed promise in simplifying complicated fistulas. These results add to the expanding body of research that supports the use of Kshara Sutra therapy for the repair of anal fistulas, offering a promising, secure, and maybe more effective option than traditional surgical procedures.

KEYWORDS:

Anal Fistula; Kshara Sutra Therapy; Ayurvedic Medicine; Parasurgical Technique; Fistula Healing; Case Series.

REFERENCES

1) H. Abcarian, “Anorectal infection: abscess–fistula,” Clin. Colon Rectal Surg., vol. 24, no. 01, pp. 14–21, 2011.

2) A. L. K. E. Ali, M. P.-K. Wong, and I. Sagap, “The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery,” Malaysian J. Med. Sci. MJMS, vol. 29, no. 1, p. 55, 2022.

3) A. Amato et al., “Evaluation and management of perianal abscess and anal fistula: SICCR position statement,” Tech. Coloproctol., vol. 24, pp. 127–143, 2020.

4) A. Amato et al., “Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR),” Tech. Coloproctol., vol. 19, pp. 595–606, 2015.

5) M. Amir, A. K. Singh, and M. Shekhar, “SIMPLIFIED TREATMENT FOR DIVERSIFIED FISTULA IN ANO,” 2021.

6) P. Bapat, V. Bapat, and D. S. Phalgune, “Pilonidal sinus extended to create transsphincteric anal fistula treated by Kshara Sutra (A medicated herbal seton) without antibiotics: A rare case report,” Indian J. Colo-Rectal Surg., vol. 4, no. 3, pp. 73–75, 2021.

7) S. Bhusari, K. Nikam, and P. Wakte, “Anal fistula: a comprehensive review,” Pharma Innov. J., vol. 8, no. 1, pp. 201–208, 2019.

8) A. M. Alwan, D. Rokaya, G. Kathayat, and J. T. Afshari, “Onco-immunity and therapeutic application of amygdalin: A review,” J. Oral Biol. Craniofacial Res., 2022.

9) A. H. Demirel and K. Seyfettin, “Silver nitrate cauterization for anal fistulas with high blind tract chemical therapy in complicated anal fistulas,” Euroasian J Hepato-Gastroenterol, vol. 3, pp. 49–53, 2013.

10) K. Faridi, P. Sreenadh, V. Mahanta, and R. Sherkhane, “Management of transsphincteric fistula-in-ano by modified conventional Ksharasutra therapy: A case report,” J. Ayurveda Case Reports, vol. 4, no. 3, p. 95, 2021.

11) D. C. Goan, “A COMPERATIVE STUDY OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT (LIFT) WITH CONVENTIONAL TREATMENT OF KSHARASUTRA THERAPY IN THE MANAGEMENT OF FISTULA IN ANO: A CLINICAL STUDY,” 2021.

12) D. C. Goan, “SPHINCTER TONE OF PATIENTS WITH FISTULA-IN-ANO TREATED BY KSHARASUTRA THERAPY WITH THE HELP OF HIGH RESOLUTION ANAL MANOMETRY: A CLINICAL STUDY,” 2021.

13) T. M. Hammond and P. J. Lunniss, “Principles and contemporary management of anal fistulas,” Gastrointest. Nurs., vol. 5, no. 2, pp. 32–40, 2007.

14) K. S. Ho et al., “Prospective randomised trial comparing ayurvedic cutting seton and fistulotomy for low fistula-in-ano,” Tech. Coloproctol., vol. 5, pp. 137–141, 2001.

15) M. IBRAHIM, M. YASSER, and A. SALEM, “Retrospective Evaluation of Outcome of Rerouting Technique in Management of Horseshoe Perianal Fistula, Single Institution Experience,” Med. J. Cairo Univ., vol. 89, no. June, pp. 505–511, 2021.

16) L. Kalal and A. Kembhavi, “A comparative clinical study on the effect of Vibhitaki Ksharasutra and Apamarga Ksharasutra in the management of Bhagandara (Fistula-In-Ano),” J. Ayurveda Integr. Med. Sci., vol. 3, no. 06, pp. 11–16, 2018.

17) S. Lalhruaizela, “Endofistula laser ablation of fistula-in-ano: a new minimally invasive technique for the treatment of fistula-in-ano,” Ann. Coloproctol., vol. 38, no. 4, pp. 301–306, 2021.

18) J. Martellucci and M. L. Vuolo, “The Seton in Anal Fistula Management,” Anal Fistula Abscess, pp. 1–14, 2020.

19) A. A. A. MB and M. H. Patel, “Management of high anal Fistula by Kshar Sutra,” Texas J. Med. Sci., vol. 13, pp. 124–131, 2022.

20) H. Nazari et al., “Advancing Standard Techniques for Treatment of Perianal Fistula; When Tissue Engineering Meets Seton: When tissue engineering meets seton for perianal fistula,” Heal. Sci. Rev., p. 100026, 2022.

21) A. Ommer et al., “German S3 guidelines: anal abscess and fistula (second revised version),” Langenbeck’s Arch. Surg., vol. 402, pp. 191–201, 2017.

22) H. K. Panigrahi, M. R. Rani, and M. M. Padhi, “Clinical Evaluation of Kshara sutra Therapy in the management of Bhagandara (Fistula-in-Ano)-A prospective study,” Anc. Sci. Life, vol. 28, no. 3, p. 29, 2009.

23) A. A. J. Pushpakumara and D. J. Anthony, “Anal manometry study in guggulu based kshara sutra in the management of fistula in ano,” SLJIM, p. 16.

24) B. RajaRam, A. Upendar, D. R. Kumar, M. Venkanna, and R. J. Prasad, “Combined Therapy Approach of Treatment for Complex Anal Fistula: A Prospective Study,” J. Chalmeda Anand Rao Inst. Med. Sci. Vol, vol. 7, no. 1, 2014.

25) P. B. Ramesh, “Anal fistula with foot extension—Treated by kshara sutra (medicated seton) therapy: A rare case report,” Int. J. Surg. Case Rep., vol. 4, no. 7, pp. 573–576, 2013.

26) J. A. Rizzo, A. L. Naig, and E. K. Johnson, “Anorectal abscess and fistula-in-ano: evidence-based management,” Surg. Clin., vol. 90, no. 1, pp. 45–68, 2010.

27) A. de S. Rós, C. H. M. dos Santos, D. M. Dourado, M. S. da Silva-Neto, I. Caldeira, and L. de O. Furtado, “Can stryphnodendron adstringens extract improve the results of fistulotomy followed by primary sphincteroplasty in the treatment of transsphincteric fistulae?,” ABCD. Arq. Bras. Cir. Dig. (São Paulo), vol. 33, 2020.

28) P. K. M. Shankar, G. N. SreeDeepthi, K. S. Rohit, and G. K. Swamy, “Ayurvedic management of fistula in ano: A systematic review protocol,” J Res Ayurvedic Sci, vol. 3, pp. 100–105, 2019.

29) G. Subhas, J. Singh Bhullar, A. Al-Omari, A. Unawane, V. K. Mittal, and R. Pearlman, “Setons in the treatment of anal fistula: review of variations in materials and techniques,” Dig. Surg., vol. 29, no. 4, pp. 292–300, 2012.

30) Q. Wang, Y. He, and J. Shen, “The best surgical strategy for anal fistula based on a network meta-analysis,” Oncotarget, vol. 8, no. 58, p. 99075, 2017.
VOLUME 06 ISSUE 08 AUGUST 2023

There is an Open Access article, distributed under the term of the Creative Commons Attribution – Non Commercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/), which permits remixing, adapting and building upon the work for non-commercial use, provided the original work is properly cited.


Our Services and Policies

Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected.

The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.

International Journal of Multidisciplinary Research and Analysis will publish 12 monthly online issues per year,IJMRA publishes articles as soon as the final copy-edited version is approved. IJMRA publishes articles and review papers of all subjects area.

Open access is a mechanism by which research outputs are distributed online, Hybrid open access journals, contain a mixture of open access articles and closed access articles.

International Journal of Multidisciplinary Research and Analysis initiate a call for research paper for Volume 07 Issue 05 (May 2024).

PUBLICATION DATES:
1) Last Date of Submission : 26 May 2024 .
2) Article published within a week.
3) Submit Article : editor@ijmra.in or Online

Why with us

International Journal of Multidisciplinary Research and Analysis is better then other journals because:-
1 : IJMRA only accepts original and high quality research and technical papers.
2 : Paper will publish immediately in current issue after registration.
3 : Authors can download their full papers at any time with digital certificate.

The Editors reserve the right to reject papers without sending them out for review.

Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected. The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.

Indexed In
Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar Avatar