Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pu...Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.展开更多
Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the ...Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the formation of fistula is different due to individual difference, consequently leading to a limited efficacy of surgical treatment. TCM has recently shown its unique advantages in accelerating the wound healing after anal fistula surgery, but the standards for syndrome differentiation of anal fistulae are still in deficiency. Thereby, this article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of anal fistulae, in order to further develop the advantages of TCM and standardize related nursing management .展开更多
Objective:The aim of this study was to evaluate the safety and efficacy of three-cavity clearance(TCC)used for the treatment of perianal abscess.Methods:A case–control study of patients with perianal abscess was cond...Objective:The aim of this study was to evaluate the safety and efficacy of three-cavity clearance(TCC)used for the treatment of perianal abscess.Methods:A case–control study of patients with perianal abscess was conducted at the Second and Third Affiliated Hospitals of Nanjing University of Chinese Medicine from June 2013 to March 2016.Clinical data from 46 patients who had TCC were analysed.At the same time,46 patients had simple incision and drainage and 46 patients had abscess drainage and cutting seton(radical abscess incision);the data from these patients were also analysed.The length of hospital stay,time of wound healing,fistula rate and anal incontinence were assessed.Results:The rate of fistula formation in the TCC group was 13.0%—significantly lower than that in the group with simple incision and drainage(39.1%,p<0.01)and similar to the group with radical abscess incision(8.7%,p>0.05).Two patients(4.3%)in the group with radical abscess incision had anal incontinence,flatus and soiling;their Wexner scores were 6 and 3,respectively.There was no anal incontinence in the TCC group or the simple incision and drainage group.There were no statistical differences in the time of wound healing and length of hospital stay among the three groups(both p>0.05).Conclusion:TCC is a safe and effective sphincter-preserving procedure for perianal abscess formation and can decrease the fistula rate after perianal abscess drainage.It appears to be a valuable method that can be used in clinical practice;however,further studies are needed to verify this finding.展开更多
文摘Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.
文摘Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the formation of fistula is different due to individual difference, consequently leading to a limited efficacy of surgical treatment. TCM has recently shown its unique advantages in accelerating the wound healing after anal fistula surgery, but the standards for syndrome differentiation of anal fistulae are still in deficiency. Thereby, this article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of anal fistulae, in order to further develop the advantages of TCM and standardize related nursing management .
基金supported by the National Nature Science Foundation of China(No.30572447,No.30973837 and No.81273944)the Jiangsu Nature Science Foundation(No.BK20151081).
文摘Objective:The aim of this study was to evaluate the safety and efficacy of three-cavity clearance(TCC)used for the treatment of perianal abscess.Methods:A case–control study of patients with perianal abscess was conducted at the Second and Third Affiliated Hospitals of Nanjing University of Chinese Medicine from June 2013 to March 2016.Clinical data from 46 patients who had TCC were analysed.At the same time,46 patients had simple incision and drainage and 46 patients had abscess drainage and cutting seton(radical abscess incision);the data from these patients were also analysed.The length of hospital stay,time of wound healing,fistula rate and anal incontinence were assessed.Results:The rate of fistula formation in the TCC group was 13.0%—significantly lower than that in the group with simple incision and drainage(39.1%,p<0.01)and similar to the group with radical abscess incision(8.7%,p>0.05).Two patients(4.3%)in the group with radical abscess incision had anal incontinence,flatus and soiling;their Wexner scores were 6 and 3,respectively.There was no anal incontinence in the TCC group or the simple incision and drainage group.There were no statistical differences in the time of wound healing and length of hospital stay among the three groups(both p>0.05).Conclusion:TCC is a safe and effective sphincter-preserving procedure for perianal abscess formation and can decrease the fistula rate after perianal abscess drainage.It appears to be a valuable method that can be used in clinical practice;however,further studies are needed to verify this finding.
