Trends in Clinical and Medical Sciences

A comparative study between seton treatment using ksharasutra and conventional surgery in fistula in ANO

Saurabh Maji\(^{1}\), Dheeraj Kumar Anchlia\(^{1}\), Prasenjit Mukhopadhyay\(^{2}\) and Shubho Chowdhuri\(^{2,*}\)
\(^{1}\) Department of General Surgery, Rampurhat Government Medical College, West Bengal, India.
\(^{2}\) Department of General Surgery, Murshidabad Medical College & Hospital, West Bengal, India.
Correspondence should be addressed to Shubho Chowdhuri at chowdhurishubho@gmail.com

Abstract

Background: Fistula-in-ano is a tract connecting the anal canal to the perianal skin. It is a complication of anorectal sepsis in approximately 25% of patients within 6 months of the incidence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated has minimal complications).
Objectives: To compare the outcome of Seton treatment using ksharasutra and Conventional fistula surgery (fistulotomy).
Methods: It was a prospective observational study. 96 patients were selected for these studies who were admitted for fistula repair Between November 2016 to December 2021 in R.G kar medical College \& Rampurhat Government Medical College. Patients coming at outpatient department of surgery with the complaint of persistent perianal discharge with or without pain were examined by per rectal digital examination and those with perianal fistula were included in the study.
Results: out of 96 patients, 50 were selected in the study group who were treated with ksharasutra and 46 patients were selected in the control group in whom fistulotomy was done. Study was male preponderance (87%). Out of 96 patients 86 were male and 10 were female. Most (84 out of 96) belong to 20-39 year age group. There were 10 cases of high anal fistula in the study group while the number was 9 in the control group. The mean duration of healing was 53.00 \(\pm\) 26.75 days in medicated Ksharasutra group whereas in fistulotomy group, mean duration of healing was 35.67 \(\pm\) 9.17 days. Ksharasutra group required significantly (P = 0.02) more number of days for healing.
Conclusion: The application of Ksharasutra is a better option not only because it is cost effective but also due to lesser postoperative complications.

Keywords:

Fistula-in-ano, Ksharasutra, fistulotomy, Seton, Perianal discharge.