Aadithyaraj K T, Sherkhane Rahul, Pandey Awadhesh Kumar, Solanki Sarika, Katkar Shivani
Dept. of Shalya Tantra, Faculty of Ayurveda, Institute of Medical Sciences Banaras Hindu University, Varanasi, 221005, India.
Dept. of Shalya Tantra, Faculty of Ayurveda, Institute of Medical Sciences Banaras Hindu University, Varanasi, 221005, India.
J Ayurveda Integr Med. 2025 Jul 25;16(5):101170. doi: 10.1016/j.jaim.2025.101170.
Anterior fistula in ano is an uncommon and challenging condition in females, with sparse literature describing effective management strategies. Surgical interventions are often complicated by the anatomical intricacies of the pelvic region. This case series explores the use of the Interception of Fistulous Tract with the Application of Ksharasutra (IFTAK) technique, a modification of traditional Ksharasutra therapy, in managing anterior fistulae in ano among female patients. Three female patients with anterior anal fistulae, two with failed prior surgical interventions, were included. Comprehensive preoperative evaluations, including clinical and radiological assessments, were performed. The IFTAK technique was employed, emphasizing tract interception and eradication of sepsis without compromising the anal sphincter. All patients achieved complete healing within 8 weeks post-procedure. No recurrence, incontinence, or significant complications were observed during a 12-month follow-up. The IFTAK technique is a promising approach for anterior fistulae in ano in females, offering high success rates with minimal complications. While the results are encouraging, validation through well-designed randomized controlled trials is essential for its broader adoption as a standard treatment for complex anal fistulas.
女性前位肛瘘是一种罕见且具有挑战性的病症,描述有效治疗策略的文献稀少。手术干预常常因盆腔区域复杂的解剖结构而变得复杂。本病例系列探讨了瘘管截除并应用药线(IFTAK)技术,这是传统药线疗法的一种改良方法,用于治疗女性患者的前位肛瘘。纳入了三名患有前位肛瘘的女性患者,其中两名先前手术干预失败。进行了全面的术前评估,包括临床和放射学评估。采用了IFTAK技术,强调瘘管截除和消除感染,同时不损害肛门括约肌。所有患者在术后8周内实现完全愈合。在12个月的随访期间未观察到复发、失禁或严重并发症。IFTAK技术是治疗女性前位肛瘘的一种有前景的方法,成功率高且并发症极少。虽然结果令人鼓舞,但通过精心设计的随机对照试验进行验证对于其作为复杂肛瘘的标准治疗方法更广泛地应用至关重要。