Abstract

PARTIAL FISTULECTOMY WITH MODIFIED CONVENTION KSHARSUTRA TECHNIQUE (MC-KST) FOR BHAGANDARA (FISTULA-IN-ANO) MANAGEMENT– A CASE REPORT

Dr. Shweta S. Renge and *Dr. Madhulika D. Tiwari

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Abstract

In the Sushruta Samhita, Bhagandara is identified as one of the Ashto Mahagada, which denotes eight formidable diseases. This condition is recurring, making treatment more challenging. As a result, it causes disruption in daily living. Because of the concern of recurrence and faecal incontinence, it has a significant impact in the surgical community. Despite numerous innovative sphincter-preserving methods, complex anal fistulas are more challenging to handle. Ksharasutra has been used for ages in Ayurveda to treat all types of anal fistulae with remarkable success. In situations with complex fistula in Ano, used Modified Conventional Ksharasutra Therapy (MC-KST) is technically used to control sepsis, promote early healing by intercepting the fistulous tract, and preserve sphincteric function. Kshar Sutra, a medicated thread made according to conventional methodology, has proven to be a significant advancement in the treatment of fistula-in-Ano. This case concern with 38-year male came with complaints of a pus discharge, from perianal region, on and off pain, difficulty in sitting since 1.5 year and constipation since one month. The fistula was operated under spinal anaesthesia by MC KST technique. The patient was treated on OPD basis with straightforward approach, exhibiting fewer surgical complications, cost-effectiveness, and a weekly change of thread. The individual recovered well after the complete removal of the tract over a period of seven weeks. The Kshara sutra treatment for Bhagandara proves to be a quicker healing process. Therefore, it stands as an efficient and minimally invasive option for treating Bhagandara.

Keywords: Fistula-in-Ano, Matra Basti, medicated thread, modified conventional ksharasutra therapy.