Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano)
Authors
Tukaram Dudhamal
Department of Shalya Tantra, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India
Madhav Baghel
Department of Shalya Tantra, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India
Chaturbhuja Bhuyan
Center for Care of Ano-Rectum Research by Indian System of Medicine and Allied (CCARRISMA), Bhubaneswar, Odisha, India
Sanjay Gupta
Department of Shalya Tantra, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India
Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano.
Aim:
To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano.
Materials and Methods:
Total 100 patients of chronic fissure-in-ano were selected and randomly divided into two groups (50 in each group). In group-A, patients were undergone by KSS; while in patients of Group-B Lord's anal dilatation followed by KSS was done under spinal anesthesia. The KSS was done once and after slough out of Ksharasutra, the wound was treated for 4 weeks and assessment of the result was done on the basis of gradation adopted.
Results:
The pain relief on 14th day in Group-A was 86% while in Group-B 100% was observed. As on 7th day in Group-A, oozing was stopped in 68% patients, while in Group-B, oozing was stopped in 82% patients. On 21st day, Group-B showed more healing (85%) as compared to Group-A (69%). In this study 68% of patients were cured.
Conclusion:
In Group-B (KSS with Lord's anal dilatation) patients were cured early as compared to patients of Group-A (KSS alone).
Keywords: Fissure-in-ano, Ksharasutra, Lord's anal dilatation, Parikartika
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