House advancement flap anoplasty for severe post-hemorrhoidectomy anal stenosis

Acar, Turan; Acar, Nihan; Tosun, Fadime; Ayaroğlu, Ç; Hacıyanlı, Mehmet

doi:10.1007/s10151-019-02139-y

Cited by 7 publications

(11 citation statements)

References 3 publications

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“…When a moderate or severe AS occurs a surgical approach with a flap (the so-called 'anoplasty') must be considered and discussed with the patient. Several different procedures have been used so far, employing a variety of different shapes and sizes of flap (mucosal, Y-V, V-Y, diamond, house, U, C, rotational S), and with healing rates reported to range between 60% and 100% [5,[12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

A tailored rhomboid mucocutaneous advancement flap to treat anal stenosis

Gallo

Stratta

Luc³

et al. 2020

Colorectal Disease

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Aim Anal stenosis (AS) is a rare but disabling disorder that often represents a complication of anorectal surgery. The aim of our study was to assess the safety and functional outcome of a modified rhomboid flap (MRF) in the treatment of moderate and severe AS. Methods Between January 2002 and September 2017, 50 consecutive patients with moderate and severe AS who underwent an MRF were retrospectively included. Anal continence (Cleveland Clinic Incontinence Score) and symptoms (Obstructed Defaecation Syndrome Score) were assessed preoperatively and postoperatively at 12 months. Furthermore, anal calibre was measured both preoperatively and postoperatively at 1, 6 and 12 months. Results The mean follow-up period was 97 AE 48.3 (33-180) months. The main aetiology was a previous excisional haemorrhoidectomy (N = 23; 46%). The mean preoperative anal calibre was 9.96 AE 2.68 (5-15) mm and there was a statistically significant improvement in all three periods (P < 0.0001) of postoperative evaluation (1, 6 and 12 months) with a mean difference, obtained comparing preoperative and 12 months anal calibre, of 14.1 AE 2.72 (P < 0.0001). Statistically significant improvement in both Cleveland Clinic Incontinence Score and Obstructed Defaecation Syndrome Score was observed in all patients at 12 months. The overall success rate was 96% (48/50 patients). Conclusion The use of an MRF is a safe and suitable option for the treatment of moderate and severe AS. The possibility of tailoring the flap, based on the degree as well as the level of AS, is the key.

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Section: Introductionmentioning

confidence: 99%

A tailored rhomboid mucocutaneous advancement flap to treat anal stenosis

Gallo

Stratta

Luc³

et al. 2020

Colorectal Disease

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“…Currently, the literature describes the following methods of surgical interventions for anal stenosis: partial lateral sphincterotomy, mucosal side flap anoplasty (Martin's modification of anoplasty), Y-V anoplasty, V-Y anoplasty, Diamond-shaped flap, House flap, U-shaped flap plastic, C-shaped flap plastic, rotary s-flap plastic. (Acar T et al, 2020;Alver O.et al, 2008;Angelchik P. D., Harms, B. A., Starling, J. R., 1993;Casadesus D. et al,2007;Farid, M. et al,2010;Leventoglu S. et al, 2022;Mehdi Tahamtan et al,2017;Oh, C., & Zinberg, J.,1982;Rakhmanine, M., Rosen, L., Khubchandani, I., Stasik, J., & Riether, R. D. ,2002).…”

Section: Resultsmentioning

confidence: 99%

“…(Rosen L.,1988) Despite significant advances in the surgical techniques, diagnosis and treatment of people with postoperative scar deformities of the perianal region, their incidence among operated patients remains unchanged. ( Blumetti J.,2017;Khubchandani I.T.,1994;Liberman H, Thorson A.G.,2000;Rosen L.,1988;Acar T, Acar N, Tosun F, Ayaroğlu Ç, Haciyanli M. ,2020)…”

Section: Introductionmentioning

confidence: 99%

Postoperative scar deformities of the perianal region: current state of the problem. (literature review)

Aksan

2022

USMYJ

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Nowadays, many surgical interventions are performed in the perianal area and on the anal canal. Each one affects the quality of the patient's future life in its own way. That is why the presented literature review is devoted to the study of the problem of postoperative scar deformities of the perianal region, because this pathology is a complication of many surgical interventions in this area. The main objective of the study is to analyze the currently available data in the following areas: the cause of postoperative scar deformities, their classification and modern treatment methods. The research method was based on the study of scientific articles published in the period from 1982 to 2022, indexed in Ukraine and international databases. This approach made it possible to identify key points in each of the areas of analysis and to systematize the obtained data. When studying the causes of postoperative anal stenosis, it can be noted that most often they represent the consequences of hemorrhoidectomies, performed in various techniques. Most scientists emphasize the importance of preventing the occurrence of anal stenosis, which implies choosing the optimal treatment method. Having systematized the literature data, I would like to note the lack of a unified approach to managing patients with this problem, as well as the lack of well-defined indications for surgical treatment. The vast majority of researchers emphasize the need to treat these patients using conservative methods, namely dietary adjustments. Regarding the methods of surgical treatment, it is necessary to note the vast quantity of available surgical techniques. At the same time, the lack of controlled prospective studies makes it difficult to evaluate and verify their results. However, it is indisputable that all of them lead to an improvement in the lives of patients and a reduction in the symptoms of stenosis. After analyzing a sufficient amount of available data, it is safe to say that the issue of postoperative scar deformities of the perianal region remains insufficiently studied and very relevant.

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“…3 Anoplasty is a safe method with acceptable results in relieving the symptoms of anal stenosis. 4 Planning of Anoplasty for Anal Stenosis Khanna, Khanna.…”

Section: Discussionmentioning

confidence: 99%

“…3 Anoplasty is a safe method with acceptable results in relieving the symptoms of anal stenosis. 4 Planning of treatment of anal stenosis depends on the severity. Milsom and Mazier 5 classified the anal stenosis in three varieties: mild, moderate, and severe.…”

Section: Discussionmentioning

confidence: 99%