Is anoplasty superior to scar revision surgery for posthemorrhoidectomy anal stenosis?Six years of experience  

作　　者：Yu-Tse Weng Kuan-Jung Chu Kuan-Hsun Lin Chun-Kai Chang Jung-Cheng Kang Chao-Yang Chen Je-Ming Hu Ta-Wei Pu 

机构地区：[1]Division of Plastic and Reconstructive Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [2]National Defense Medical Center,Taipei 114,Taiwan [3]Division of Thoracic Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [4]Division of Plastic and Reconstructive Surgery,Department of Surgery,Zuoying Branch,Kaohsiung Armed Forces General Hospital,Kaohsiung 813,Taiwan [5]Division of Colon and Rectal Surgery,Department of Surgery,Taiwan Adventist Hospital,Taipei 105,Taiwan [6]Division of Colon and Rectal Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [7]Division of Colon and Rectal Surgery,Department of Surgery,Songshan branch,Tri-Service General Hospital,National Defense Medical Center,Taipei 105,Taiwan

出　　处：《World Journal of Clinical Cases》2022年第22期7698-7707,共10页世界临床病例杂志

摘　　要：BACKGROUND Anal stenosis is a rare but frustrating condition that usually occurs as a complication of hemorrhoidectomy.The severity of anal stenosis can be classified into three categories:mild,moderate,and severe.There are two main surgical treatments for this condition:scar revision surgery and anoplasty;however,no studies have compared these two approaches,and it remains unclear which is preferrable for stenoses of different severities.AIM To compare the outcomes of scar revision surgery and double diamond-shaped flap anoplasty.METHODS Patients with mild,moderate,or severe anal stenosis following hemorrhoidectomy procedures who were treated with either scar revision surgery or double diamond-shaped flap anoplasty at our institution between January 2010 and December 2015 were investigated and compared.The severity of stenosis was determined via anal examination performed digitally or using a Hill-Ferguson retractor.The explored patient characteristics included age,sex,preoperative severity of anal stenosis,preoperative symptoms,and preoperative adjuvant therapy;moreover,their postoperative quality of life was measured using a 10-point scale.Patients underwent proctologic follow-up examinations one,two,and four weeks after surgery.RESULTS We analyzed 60 consecutive patients,including 36 men(60%)and 24 women(40%).The mean operative time for scar revision surgery was significantly shorter than that for double diamondshaped flap anoplasty(10.14±2.31[range:7-15]min vs 21.62±4.68[range:15-31]min;P<0.001).The average of length of hospital stay was also significantly shorter after scar revision surgery than after anoplasty(2.1±0.3 vs 2.9±0.4 d;P<0.001).Postoperative satisfaction was categorized into four groups:45 patients(75%)reported excellent satisfaction(scores of 8-10),13(21.7%)reported good satisfaction(scores of 6-7),two(3.3%)had no change in satisfaction(scores of 3-5),and none(0%)had scores indicating poor satisfaction(1-2).As such,most patients were satisfied with their quality of life after surgery other

关 键 词：Anal canal ANOPLASTY Scar revision STENOSIS Surgery-induced tissue adhesions Surgical flaps 

分 类 号：R657.18[医药卫生—外科学]