Abstract
Anterior fistula in ano is an uncommon and challenging condition in females, with sparse literature describing effective management strategies. Surgical interventions are often complicated by the anatomical intricacies of the pelvic region. This case series explores the use of the Interception of Fistulous Tract with the Application of Ksharasutra (IFTAK) technique, a modification of traditional Ksharasutra therapy, in managing anterior fistulae in ano among female patients. Three female patients with anterior anal fistulae, two with failed prior surgical interventions, were included. Comprehensive preoperative evaluations, including clinical and radiological assessments, were performed. The IFTAK technique was employed, emphasizing tract interception and eradication of sepsis without compromising the anal sphincter. All patients achieved complete healing within 8 weeks post-procedure. No recurrence, incontinence, or significant complications were observed during a 12-month follow-up. The IFTAK technique is a promising approach for anterior fistulae in ano in females, offering high success rates with minimal complications. While the results are encouraging, validation through well-designed randomized controlled trials is essential for its broader adoption as a standard treatment for complex anal fistulas.