REPAIR OF ANAL STRICTURE AND MUCOSAL ECTROPION WITH Y-V OR PEDICLE FLAP ANOPLASTY

Cicatricial stenosis and mucosal ectropion of the anal canal are disab ling complications of anal surgery or disease and are extremely diffic ult to manage. Perusal of the literature reveals minimal consensus as to the most successful way to surgically manage patients with these co nditions. During a 4-year period, we managed 19 patients who had anal stenosis (n = 14) or anal ectropion (n = 5). Eighteen of these patient s had prior anal rectal surgery. We employed a Y-V anoplasty or advanc ement diamond-shaped pedicle flap and obtained satisfactory to excelle nt results in all patients. Concurrent lateral internal sphincterotomy was also employed in selected patients who had a fibrotic muscular co mponent contributing to the stenosis. Based on our cohort of patients, we believe the pedicle skin flap technique is slightly superior to th e Y-V anoplasty in functional and cosmetic results.