Outcomes of Advancement Flaps Used in the Treatment of Anal Stenosis Developing After Hemorrhoid Surgery: One Center Experience

Abstract

Aim: Anal stenosis develops due to anoderm scarring caused by any pathologic condition but usually secondary to surgical trauma. It is a preventable problem with negative social and medical implications for patients. In our study we intend to share our results with the use of advancement flaps in the treatment of anal stenosis. Method: The demographic and clinical characteristics of 10 patients who underwent surgery for anal stenosis due to hemorrhoidectomy between 2012 and 2018 were retrospectively reviewed. Results: Nine (90%) of the patients were male and 1 (10%) was female. Mean age of the patients was 54 (27-81) years. A total of 11 procedures were performed on 10 patients. Hemorrhoidectomy was the common etiology for all patients. Most common presenting complaints were painful defecation and difficulty passing stool in 5 patients (50%) each. In this study, 4 (40%) patients had V-Y, 3 (30%) had house, 2 (20%) had diamond, and 1 (10%) had dufourmental advancement flap. Mean length of hospital stay was 2 (1-3) days. One patient developed surgical site infection that was succesfully managed medically. Mean follow-up period was 39 (6-72) months. One patient had a subsequent contralateral diamond flap advancement because of persistent complaints and recurrence. No other recurrence was observed during follow-up. Conclusion: The best remedy for anal stenosis is prevention. Therefore, during common surgical procedures like hemorrhoidectomy, one must refrain from interventions that will result in anal stenosis. However, advancement flaps used in the treatment of moderate to severe anal stenosis are effective and offer commendable results.

Keywords

• Anal stenosis
• hemorrhoidectomy
• advancement flap