Kshara Sutra In Fistula - Why It Is Better Than Modern Surgery?

Anal fistula is an anorectal disorder for which different treatment methods have been advocated from time to time. Certain conventional surgical methods like Fistulotomy and Fistulectomy have been used but they are associated with complications like delayed healing, the risk of stenosis (abnormal narrowing of the blood vessels or other tubular organs) etc.

Modern techniques of surgery like the ‘lay-open' method and ‘anorectal pathology' come with a similar number of intricacies like high rates of recurrence and anal incontinence, prolonged hospitalization etc. Therefore, even today this particular disease has no satisfactory method of treatments in modern surgery.

However, in Ayurveda, about 2000 years ago, the great Indian Surgeon Acharya Sushrata first narrated about the ‘Kshara', which was later, compiled into the work ‘Sushrat Samhita'. Kshara Sutra is a minimal invasive ayurvedic parasurgical technique, effective for the treatment of anorectal disorders like hemorrhoids, fistula-in-ano, Anal fissure and pilonidal sinus.

Why is it used to treat Fistula-In-Ano?
In this technique of surgery, a thread also called a Kshar Sutra thread is specially prepared which acts by herbal chemical cauterization (the medical practice of burning a part of the body to remove or close off a part) and cures diseases. Hence, this is the safest and cost-effective method to treat Fistula-In-Ano.

Procedure-
The Kshar Sutra is a surgical linen thread of size 20 is coated with ayurvedic herbs with no side effects. There are three types of Kshar Sutra based on the number of coatings and the quality of materials used. Each patient gets customized treatment as per his or her own requirements.

First, a malleable probe is made to pass through the external opening of the fistula to the internal aperture in the anal canal. It is then taken out gently through the anal opening along with the Kshar. Later both the ends are tied together.

A cumulative effect of the drugs coated on the Kshar exerts a powerful debridement effect on the fistula tract & prompts healing by new & healthy granulation tissues. Thus, this mechanism of drug delivery directly heals the tissues involved in an optimal time period.

The thread is changed once every week that gradually helps heal the infected tract. As a result, the chances of recurrence are minimal.

Benefits of Kshar Sutra over modern surgery techniques-

1. An out-patient treatment, it is mostly conducted under local anesthesia
2. The most significant benefit of Kshar Sutra therapy over conventional modern surgeries is that the muscles that support the anus and controls bowel movements are not dissected and hence the chances of anal inconsistency are lowered.
3. The probability of anal stenosis (narrowing of the anal canal after treatment) are almost nil
4. There is no damage done to Anal Sphincter
5. Minimal chances of recurrence and bleeding
6. Hospital stay is only for 4-5 hours
7. There is no need for antibiotic coverage.
8. The patient can get back to routine life after 3-5 days of the surgery
9. Post-treatment recovery is speedy and without any complications