Surgical management of post hemorrhoidectomy benign anal stenosis - an experience of eleven patients

Naresh K. Chovatia; Bhavin A. Bhuva; Praveen K. Sharma; Mukesh M. Pancholi

doi:10.18203/2349-2902.isj20233929

Authors

Naresh K. Chovatia Star Surat Piles and Colorectal Clinic, Surat, Gujarat, India
Bhavin A. Bhuva Star Surat Piles and Colorectal Clinic, Surat, Gujarat, India
Praveen K. Sharma Department of Surgery, Government Medical College, Surat, Gujarat, India
Mukesh M. Pancholi Department of Surgery, Medical College Baroda, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20233929

Keywords:

Benign anal stenosis, Hemorrhoidectomy, Diamond flap anoplasty

Abstract

Anal stenosis is a serious but fortunately rare complication of anorectal surgical procedures. It has been shown that approximately 90% of anal stenosis develops after hemorrhoidectomy, and 1.5-3.8% of all hemorrhoidectomies. The surgical methods such as stricture release, sphincterotomy and advancement flap are common techniques to repair anal stenosis. This is a retrospective observational study of 11 patients with benign anal stenosis managed surgically from January 2017 to April 2022. A total of 11 patients (nine males and two females), mean age 45.6 years (range- 33-90 years), underwent various surgical procedures like partial lateral internal sphincterotomy (PLIS) (n=04), V-Y flap anoplasty (n=03) and diamond flap anoplasty (n=04) with PLIS in both types of anoplasties as an associated procedure. After follow up period of two months to three years, all patients of PLIS had 100% healing rate, V-Y flap anoplasty had 66% healing rate with re-stenosis in one patient and diamond flap anoplasty had 100% healing rate with no restenosis. In moderate to severe anal stenosis and failed conservative management, various anoplasty techniques can be used with lateral sphincterotomy with good results, especially diamond flap anoplasty.

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