Online ISSN: 2515-8260

Keywords : Fistulectomy


CLINICO-PATHOLOGICAL STUDY OF ANAL CANAL DISEASES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

Dr.Kuldeep Kumar, Dr. Ashok Kumar, Dr. Vaishali, Dr. Ghanshyam Gahlot

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3372-3384

Introduction: Anal canal diseases include different pathologic disorders that generate significant patient discomfort and disability. Although these are frequently encountered in general medical practice, they often receive only casual attention and temporary relief. 
Aim and Objective: This study was intended for a clinico-pathological analysis of different conditions with Clinical presentation and their clinical diagnostic and treatment modalities based on various demographic features and associated conditions.
Material and methods: The data were collected from under study population through a pretested and semi-structured schedule, which was designed in such a manner that more information regarding demographic profile, risk factors, morbidity and diagnosis could be collected.100 patients aged between 21to>50 were selected who were diagnosed as various Anal canal diseases in admitted and underwent surgical interventions during Nov 2020 to Oct 2021.
Results: Data related to objectives of the study were collected and analysed. Patients belonging to the age group 31-40 constituted the majority (33%). There was male predominance with (75%) male and (25%) female. According to related co-morbidities most of cases had Constipation (94%). hemorrhoids were the most common incidence of diagnosis 50%, anal fistula (18%), anal fissure (13%), Abscess (8%), anal polyp (2%) and patients have anal neoplastic (5%) condition which all were malignant and other various conditions. Most Anal canal diseases were revealed to type of management, majority of patients (41%) had hemorrhoidectomy, followed by (15%) patients had fistulectomy, (8%) had I&D, (6%) each had fistulectomy with hemorrhoids ligation and Lord's dilatation with hemorrhoids ligation, (2%) patients each had excision of polyp and Lord's stitching. 3% patients each had abdominoperineal resection and lateral sphincterotomy. (4%) patients each had lord's dilation with excision of sentinel tags and conservative management.
Conclusion: Anal canal disorders include a diverse group of pathologic conditions like hemorrhoids, anal fissure, fistula, perianal Abscess etc. Although non-operative management is often the initial treatment, surgical option always needs to be a component of the armamentarium for dealing with these diverse processes. Thus, surgeons need to be aware of the aspects of approaching the patient with anal pathology, as ultimate recovery and function depend on accurate and proper evaluation and management.

Ligation of Intersphincteric Fistula Tract (LIFT) versus conventional fistulectomy in management of low fistula in ano: A comparative study from a tertiary hospital

Dr. Balaji Laxmanrao Salunke, Dr. Lamture Yeshwant Ramrao

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2169-2174

Background: Fistula in ano is an abnormal track connecting the anal canal with the perineum. Different treatment modalities are available for managing anal fistulae, such as fistulotomy, fistulectomy, ligation of intersphincteric fistula tract (LIFT), seton placement, advancement flaps, and use of biological agents like fibrin glue. The present study aimed to compare Ligation of intersphincteric Fistula Tract (LIFT) versus conventional fistulectomy in treating low fistula in ano at a tertiary hospital.
Material and Methods: Present study was a single-center, comparative study conducted on patients suffering from low anal fistula between 18-55 yrs.
Results: 80 patients were divided into groups Group A (LIFT procedure) & Group B (conventional fistulectomy), with 40 patients in each group. Among various Intra-operative & Postoperative Factors, we noted that Group A (LIFT) had less mean duration of surgery, less hospital stay, less need for analgesics, less mean duration of wound healing, less mean duration of return to work as compared to Group B (Conventional Fistulectomy) & difference was significant statistically (p<0.001). Postoperative complications were more minor in Group A (LIFT) (only 1 case of incontinence) as compared to group B (Conventional Fistulectomy) (2 cases of Wound infection/Abscess, two instances of incontinence & 1 patient of recurrence), but the difference was not significant statistically.
Conclusion: The ligation of intersphincteric fistula tract (LIFT) procedure is easy to learn, perform, safe, has a high healing rate, low morbidity, quickly treats fistula in ano & better fecal continence preservation compared to open fistulectomy.