Comparative Evaluation of Iftak Surgery and Fistulectomy in the Management of Fistula-in-Ano: A Detailed Literature Review

Fistula-in-ano is a chronic inflammatory condition characterized by an abnormal tract between the anal canal and perianal skin, most commonly arising from cryptoglandular infection. Surgical intervention remains the mainstay of treatment; however, recurrence and postoperative complications such as fecal incontinence continue to challenge surgeons. Fistulectomy, a conventional surgical method, involves complete excision of the fistulous tract but is associated with significant tissue loss, postoperative pain, and delayed healing. IFTAK (Interception of Fistulous Tract with Application of Ksharasutra) is an Ayurvedic parasurgical technique that offers a minimally invasive and sphincter-preserving approach. This review aims to compare both modalities based on healing time, postoperative pain, recurrence, sphincter preservation, and overall outcomes. The literature suggests that while fistulectomy is effective in simple fistulas, IFTAK provides superior outcomes in complex and recurrent cases with minimal morbidity.