Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano).

BACKGROUND

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 14(th) day in Group-A was 86% while in Group-B 100% was observed. As on 7(th) day in Group-A, oozing was stopped in 68% patients, while in Group-B, oozing was stopped in 82% patients. On 21(st) 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).