Dhivya Kumar, (2023) A Comparative study between Ligation of Intersphincteric Fistula Tract and Fistulectomy in the Treatment of Perianal Fistula in a Tertiary Care Centre. Masters thesis, Madras Medical College, Chennai.
Full text not available from this repository.Abstract
BACKGROUND AND OBJECTIVES: A fistula-in-ano is a granulation tissue lined tract, which connects an opening on the perianal skin (external) to another opening inside the anal canal or the lower rectum (internal). It is the chronic phase of anorectal suppuration. Surgical therapies are required to achieve a cure which include fistulotomy, fistulectomy, excision of tract with primary closure and staged operations which help to reduce recurrences. Recent advances being fibrin glue, fistula plugs, LIFT and VAAFT procedures. To assess the following parameters in patients with perianal fistula treated with LIFT and conventional Fistulectomy: a. Post operative pain, b. Post operative wound healing time, c. Fecal incontinence, d. Recurrence after surgery. METHOD: This prospective randomised control trial was conducted in patients with perianal fistula admitted in the Institute of General Surgery in Madras Medical College, Chennai. 30 patients divided into two groups of 15 each admitted in the period between June 2022 and December 2022 GROUP A - Patients undergoing LIFT GROUP B - Patients undergoing Fistulectomy. RESULTS: There is significant difference between two groups when compared with post operative pain with p-value<0.05 i.e., 0.02. In our study, the average post operative pain measured by Visual Analog Score was 2 in Group A (LIFT) and 5 in Group B (Fistulectomy). There is significant difference between two groups when compared with wound infection which is significant with p-value<0.05 i.e. 0.01. There is significant difference between two groups when compared with recurrence of pain with p-value<0.05 i.e., 0.009. CONCLUSION: LIFT (Ligation of Intersphincteric Fistula Tract) technique has lesser post-operative pain and wound infection, with better wound healing rates, compared to Fistulectomy. The duration of hospital stay is short with early resumption of daily activities in patients undergoing LIFT. The risk of incontinence and recurrence is also minimal with LIFT. Hence, it is concluded that, compared to fistulectomy, LIFT (Ligation of Intersphincteric Fistula Tract) procedure is cost-effective, safe and preferred sphincter saving technique for perianal fistula.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 220120100507 |
| Uncontrolled Keywords: | Perianal fistula, Ligation of Intersphincteric Fistula Tract, Fistulectomy, Recurrence. |
| Subjects: | MEDICAL > General Surgery > MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Jan 2024 06:09 |
| Last Modified: | 19 Jan 2024 16:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21297 |
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