Volume : V, Issue : X, October - 2015

A Comparative Study of Management of Fistula–In Ano with Partial Fistulectomy Combined With Medicated Seton Technique and Conventional Fistulectomy

Dr Sagarkumar Gupta, Dr Kaushalendra K Vegad, Dr Ramakant Manolkar

Abstract :

 Background Fistula in ano is one of the commonest problems faced in today’s world. It is still the disease of the present and has acquired much significance today in the background of a rising incidence of fistula in ano.Several techniques have been described for the management of fistula–in–ano, but all carry their own risks of recurrence and incontinence. Technology has evolved over the past 2 decades that may enable surgeons to deal with this troublesome issue with greater success. This study summarizes the history of fistula–in–ano management, the current techniques available, and describes new technologies. Aims And Objectives 1. To review & study patients who presented with Fistula–in–ano. 2. To study the efficacy of partial fistulectomy combined with medicated seton technique. 3. To compare the efficacy of this technique with the conventional techniques of fistulectomy. 4. To study and compare the morbidity associated with this technique with conventional methods. 5. To study and compare the early and late post operative complications of this technique with the conventional techniques. Materials and methods A comparative study of 50 patients of Fistula in ano starting from September 2012 to September 2014 was carried out in Dhiraj Hospital, SBKS medical college, Sumandeep Vidyapeeth, Pipariya, Vadodara. These patients were divided into 2 groups of 25 each–one group undergoing conventional fistulectomy and another group undergoing technique of medicated seton insertion. All admitted patients had undergone the required work up for the diagnosis and treatment for fistula–in–ano. All patients were monitored with clinical and blood examinations and some special investigations like fistulogram, CT scan, MR fistulogram, sigmoidoscopy. Then patients were classified into simple and complex anal fistula and then they were divided into 2 groups–one treated with conventional technique of fistulectomy ,second group treated surgically with partial fistulectomy combined with medicated seton technique. The post op complications like recurrence, incontinence, pain and cosmetic problems and outcome were also evaluated for both the groups. A statistical analysis was carried out compå the efficacy of both the techniques. The follow up study was carried out according to the extent of fistulous tract, approximately extending from 2 months to 1 year. Results The patients were of various ages, ranging from 18–62 years, with most of them in their 3rd or 4th decade, with a mean age of 38.62 years. Incidence among sexes (male: female) was in the ratio of 49:1 showing male predominance. Pus discharge was the commonest symptom complained by all the patients undergoing this study followed by itching and anal pain. On examination most of the patients presented with low anal type of fistula and single external opening. In comparison with both the technique medicated seton technique was much better for high and longer fistula and also of high healing rate compared to conventional fistulectomy. Patients were operated and after discharge were advised follow–up. On follow–up the pus discharge was present in all cases but there was no pain and patients were able to carry out their routine without much discomfort except there was slight itching in some of the cases. Conclusion This study signifies that the management of fistula on ano by partial fistulectomy combined with medicated seton technique is a much better procedure as compared to conventional fistulectomy technique with faster healing and least complications.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr SagarKumar Gupta, Dr Kaushalendra K Vegad, Dr Ramakant Manolkar A Comparative Study of Management of Fistulain � Ano with Partial Fistulectomy Combined with Medicated Seton Technique and Conventional Fistulectomy Indian Journal of Applied Research, Vol.5, Issue : 10 October 2015

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