Minimal invasive <i>Kshara Sutra</i> technique (MIKST) for the treatment of trans-sphincteric anal fistula - a single-center retrospective study in India

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Since ages, anal fistulas have posed a significant challenge for surgeons because of their unpredictable branching and high chances of recurrence after treatment. Although multiple management approaches have been introduced by skilled surgeons, none have been completely effective. In Ayurveda, a traditional Indian medical practice, Kshara Sutra (Ayurvedic seton) therapy is used to treat fistulas, but the longer this Kshara Sutra is in situ; the more pain and discomfort the patient endures. Materials and methods This work imbibed a long-term retrospective observational study where the authors enrolled 215 patients of trans-sphincteric anal fistula who underwent a modified technique of Kshara Sutra named as MIKST, minimal invasive Kshara Sutra technique aimed to preserve anal sphincter complex and to overcome the challenging barriers faced in conventional Kshara Sutra therapy. The data are tabulated and assessed through primary outcome of healing of postoperative fistula wound, postoperative pain, number of Kshara Sutra sessions, and secondary outcome of anal incontinence and recurrence. Results The study found a significant mean operative time of 15.307 ± 2.76 minutes and patient hospital stay of 2.16 ± 0.37 days. Postoperative pain was low, with a mean score of 1.16 ± 0.86 on the visual analog scale. The mean number of Kshara Sutra change sessions was 2.553 ± 0.81, a

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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