Retrospective Observational Cohort Study on Quality of Life in Anal Fistula Patients Managed with Ksharasutra, Complete Fistulectomy and Integrated Treatment.
DOI:
https://doi.org/10.70066/jahm.v14i6.2944Keywords:
Bhagandara, Cohort study, Complete Fistulectomy, Fistula in Ano (FIA), Ksharasutra ligation (KSL), observational study, Partial fistulotomy, Quality of Life (QoL)Abstract
Background: Bhagandara (Fistula-in-ano) is a disease of the anal canal, for the management of which various surgical procedures and Ksharasutra ligation (KSL) are the majorly performed routine procedures based on the complexity of Fistula-in-ano (FIA). These have variable outcomes affecting the Quality of Life (QoL), which is seen clinically. As there is a lack of data on QoL of patients who are treated with KSL only, Ksharasutra ligation + Partial fistulotomy (KSL+PF), and Complete fistulectomy (CF) so in this study, we aimed to evaluate the effect on QoL in patients who are treated with KSL and KSL+PF and CF. Study design: Retrospective observational cohort study Objectives: To evaluate the effect on QoL in Fistula in Ano (FIA) patients treated with KSL, CF and KSL+PF. Materials and methods: The study included 95 participants treated by KSL, CF, and KSL+PF for complaints of Fistula in Ano at KLE for the duration of 6 years. Observations: The participants were categorized in three groups namely KSL (n=44), CF (n=18), KSL+PF (n=33) based on the type of surgeries performed. Amongst all the participants, simple FIA were 18 whereas complex FIA were 77. The analysis of pain via VAS, VDS and postoperative complications, along with quality of life (QoL) was done where KSL demonstrated significantly better outcomes in comparison to CF across all the domains: Domain 1, Domain 3 and Domain 4 (All p < 0.001). Similarly, KSL+PF has shown significantly better outcomes in comparison to CF across all the domains (all p <0.001) these findings remained significant after adjustment for baseline clinical variables in multivariable regression analysis. Conclusion: KSL & KSL+PF group exhibited better QoL scores compared to CF group. Statistically comparable QoL scores were seen in KSL and KSL+PF but clinically improved QoL was observed in the KSL+PF Group.
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