DOI: http://dx.doi.org/10.18203/2349-2902.isj20183204

Comparison of “medicated seton versus fistulectomy” in the management of fistula-in-ano in tertiary care hospital

Swapnil P. Madankar, Girish L. Jatkar, Bhagwat Bhusari

Abstract


Background: Fistula-in-ano is defined as communication between anal canal or rectum to external surface.  The main objectives of the study are to compare management of fistula-in-ano by “Medicated seton Vs Fistulectomy” and its outcome in term of complications and the recurrences if any.

Methods: This study is a randomized controlled trial. Total 46 consecutive patients presenting to the Department of Surgery at SVNGMC Medical College Yavatmal with fistula-in-ano during the time of Sep-13 to Oct-15 were included in the study.  All the patients were studied as per the proforma and treated by either medicated seton or fistulectomy.

Results: It was observed that operative time required (min) in medicated seton was significantly less than fistulectomy procedure. Hospital stay (days) required was significantly more in fistulectomy procedure as compared to medicated seton. Time required for complete healing (days) was significantly more in medicated seton as compared to fistulectomy.

Conclusions: It is concluded that treatment of fistula-in-ano by medicated seton is simple, easy, and safe. Medicated seton treatment is an outpatient procedure and can be done in a minor operation theatre or even at Primary Health Care level. Procedure not left with a large perineal wound and its associated morbidity.


Keywords


Fistulo in ano, Fistulectomy, Medicated seton

Full Text:

PDF

References


Malik AI, Nelson RL. Surgical management of anal fistula: a systemic review. Colorect Dis. 2008;10:420-30.

Datta G, Bain J, Ray A, Dey S, Das N, Das B. Comparing Ksharasutra (Ayurvedic Seton) and open fistulotomy in the management of fistula-in -ano. Journal of Natural Sci, Biol Med. 2015;6(2):406-10.

Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20.

Shukla NK, Narang R, Bapat RD, Hande A, Nair NGK, Radhakrishnas, et al. Multicentric randomised controlled clinical trial of Ksharsootra in the management of fistula-in-ano. Indian J Med Res. 1991;94:177-85.

Reddy VM, Reddy MM, Sreeram S. A comparative study of Ayurvedic medicated seton (Kshara Sutra) and fistulectomy in Anorectal Fistule. Int J Sci Appl Res. 2015;2(8):64-8.

Gupta S, Khanna V, Gupta G, Bhardwaj A. A Compatative study to evaluate the efficacy of standard fistulectomy procedure and kshar-sutra ligation in the management of fistula-in-ano. Int J Res Ayurveda Pharma. 2014;5(4):470-3.

Mohite JD, Gawai RS, Rohondia OS, Bapat RD. Ksharsootra (medicated seton) treatment for fistula-in-ano. Indian J Gastroenterol. 1997;16(3):96-7.