Surgical treatment of anal stenosis  

作　　者：Giuseppe Brisinda Serafino Vanella Federica Cadeddu Gaia Marniga Pasquale Mazzeo Francesco Brandara Giorgio Maria 

机构地区：[1]Department of Surgery,Catholic University Hospital "Agostino Gemelli" [2]Department of Surgery, University Hospital "Tor Vergata" [3]Department of Surgery,Hospital "Maria Paternò Arezzo"

出　　处：《World Journal of Gastroenterology》2009年第16期1921-1928,共8页世界胃肠病学杂志（英文版）

摘　　要：Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classification of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely difficult to interpret the results of the various anoplastic procedures described in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms.Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classifi cation of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely diffi cult to interpret the results of the various anaplastic procedures de in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms.

关 键 词：Anal canal surgery Anal stenosis ANOPLASTY HEMORRHOIDECTOMY COMPLICATIONS Lateral internal sphincterotomy Surgical flap 

分 类 号：R657.1[医药卫生—外科学] R657.4[医药卫生—临床医学]