ANOPLASTY FOR THE TREATMENT OF ANAL STENOSIS

BACKGROUND: Cicatricial stenosis of the anal canal is a disabling comp lication of anal surgery. Many different surgical techniques have been described for the management of this disorder. METHODS: In this study we report 42 patients with severe anal stricture treated with anoplas ty. Twenty-nine of these patients underwent a Y-V anoplasty while 13 h ad a diamond flap anoplasty. All patients were seen 4 weeks, 6 months, and 2 years after surgery. RESULTS: Three patients who had undergone Y-V anoplasty experienced, as a minor early operative complication, a suture dehiscence and 1 patient had an ischemic contracture of the lea ding edge of the flap. Two patients had urinary infections. None of th ese complications needed further surgical intervention and were all ma naged with local and medical therapy. At 2 years follow-up 93% of pati ents had been successfully treated while the remaining 7% had improved . Fifteen percent of patients who had undergone Y-V anoplasty complain ed of postoperative complications, and all patients with incomplete re sults had been treated with an Y-V anoplasty. CONCLUSIONS: Based on ou r cohort of patients we believe that both techniques are satisfactory in treating anal stricture but diamond flap anoplasty seems more relia ble because of the reduced tension at the suture line and the better b lood supply to the flap. (C) 1998 by Excerpta Medica, Inc.