IFTAK (Interception of Fistulous Tract with Application of Ksharasutra) technique: a minimally invasive solution for recurrent fistula-in-ano-a case series analysis.

PURPOSE: The purpose of the case series analysis is to explore the multifactorial causes of recurrent fistula-in-ano, highlighting the limitations of conventional treatment methods, and to evaluate the potential of the IFTAK (Interception of the Fistulous Tract with Application of Ksharsutra) technique. By addressing challenges such as incontinence and relapse associated with recurrent fistulas, the study aims to demonstrate how the IFTAK approach, with its sphincter-sparing and healing-promoting properties, offers an effective and sustainable solution for better management and reduced recurrence rates.

METHODS: This retrospective study involved 10 patients with recurrent fistula-in-ano, consecutively selected on the basis of the date of intervention and treated using the IFTAK technique. Preoperative imaging and clinical assessments identified the fistulous tract. Intraoperatively, the tract was intercepted at the inter-sphincteric plane, followed by Ksharasutra application. Postoperative care included sitz baths, dressing changes, and weekly thread replacement until healing.

RESULTS: Among 10 patients (8 males, 2 females; average age 39 years), cut-through was achieved in 2-3 months, depending on the fistula complexity. Weekly follow-ups ensured healing, with no recurrence observed in 10 patients over 12 months (1 year).

CONCLUSION: IFTAK is a minimally invasive and effective technique for managing complex and recurrent fistula-in-ano, offering reduced recurrence, sphincter preservation, and faster recovery. Further randomized trials are needed to establish its long-term efficacy with an extended follow-up period and universal applicability.