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Selection Of Patients ---->
The patients have been selected from the ano-rectal clinic of S.S. hospital, BANARAS HINDU UNIVERSITY. Most of these patients came with aprimary complaint of a chronic discharging sinus in the peri-anal region while others were reffered from the other clinical departments of the hospitals with diagnosis of ‘fistula-in-ano’.Of the reffered patients , there is a good number of cases who had undergone an operative treatment either for an abscess or for the fistula-in-ano,and on recurrence of the disease they were later reffered to be subjected to this special caustic ligature. The cases are examined carefully and properly recored on a specially designed proforma.
As a rule, the treatment is considered to be effective in all types of fistula-in-ano,but the patients where it is technically impossible or diffcult to apply apply a thread were considered unfit for this treatment. These include fistulus which were either exceptionally high or presented a number of openings on the surfaces.It is justified to mention here that it has been possible to apply this thread in some high rectal fistulae cases (fig. 4) under general anaesthesia.Similiarly many patients possessing multiple fistulae have also been treated by these method. Still, the cases who are customarily described to have a ‘water-can’ apperance where not considred fit for this treatment.Besides this,the patient having an associated serious pathology e.g. rectal carcinoma, active tuberculosis, advanced anaemia, associated diabetes etc. are taken only after controlling the general conditions.Similarly pregnancy is considered an unsuitable period and treatment is best avoided.
In spite of the preceding limitations,it was realized that the number of patients who are admissible to this treatment constitutes the majority of the total number of patients suffering from this disease.The number of patients who are refused this treatment is very small.The majority of those patients who suffer from a simple single fistula can be benefited by this most convenient method of treatment.
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