TREATMENT OF TRANS-SPHINCTERIC FISTULA-IN-ANO WITH COMBINED THERAPY OF LASER AND KSHARA SUTRA - A CLINICAL STUDY.

60 Patients are registered and divided into two groups. Each group consist of 30 patients but in 2 patients from group A and 1 patient from group B are dropped out so all data given in 57 patients only  . Group A- conventional Kshara Sutra ligation. Group B- LASER therapy with Kshara Sutra Application as SMAK technique.

In group A- conventional kshara sutra ligation will be done from external opening to internal opening by probing. In group B- The Diode LASER (Radial Fiber) ablation done from external opening up to the level lateral to submucosa and from submucosa to the internal opening Kshara Sutra will be applied as submucosal application of Kshara Sutra (SMAK) technique.

Then to enhance the healing of wound by the application of hot sitz bath, proper cleaning of wound with sterile gauze.adjuvent therapy includes haritaki churna 5gm H.S

above study clinically assest on pain,itching,and discharge.it showed that after four follow up group A showed  82.63%relief in pain,92.02%in itching,81.82% in discharge while Group B showed 100% result in pain,itching,discharge and P value showed <0.001 which is highly significant but if analyse the full course of complete remission of fistula -Group B(trial group) showed complete remission at 42th day and Group A(controlled group) showed at 63th day.

Chi-squre,wicoxom(Z) and ,independent test applied for statistical analysis.

conclusion was that treatment given in both group are highly significant but trial group showed better result in terms of less pain,itching and discharge,less hospital visits,less discomfort,early returned to the normal life.