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Anal Stenosis

  • Dong Woo KangEmail author
Chapter

Abstract

About 90% of anal stenosis is caused by postoperative stenosis from hemorrhoidectomy, due to excessive excision. It is classified as mild, moderate, and severe stenosis by the degree of stenosis and low, middle and high stenosis by the site of the stenosis. In mild or moderate anal stenosis, sufficient fluid supply and bulking agent such as stool softeners and fiber supplements help the anal canal to dilate naturally. A surgical method should be determined under the preference of the surgeon and range, degree, and site of stenosis such as Y-V advancement flap, rhomboid-shaped or diamond-shaped advancement flap, or house flap for moderate stenosis and rotational flap for severe stenosis.

Keywords

Anal stenosis Classification Advancement flap 

References

  1. 1.
    Khubchandani IT. Anal stenosis. Surg Clin N Am. 1994;74(6):1353–60.CrossRefGoogle Scholar
  2. 2.
    Milsom J, Mazier W. Classification and management of postsurgical anal stenosis. Surg Gynecol Obstet. 1986;163(1):60–4.PubMedGoogle Scholar
  3. 3.
    Liberman H, Thorson AG. How I do it. Anal stenosis. Am J Surg. 2000;179(4):325–9.CrossRefGoogle Scholar
  4. 4.
    Puia IC, Bodea R, Neagoe RM. Hemorrhoidectomy and anal stenosis. J Gastrointestin Liver Dis. 2015;24:395–6.PubMedGoogle Scholar
  5. 5.
    Brisinda G. How to treat haemorrhoids: prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582–3.CrossRefGoogle Scholar
  6. 6.
    Wilson MS, Pope V, Doran HE, Fearn SJ, Brough WA. Objective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial. Dis Colon Rectum. 2002;45:1437–44.CrossRefGoogle Scholar
  7. 7.
    Katdare MV, Ricciardi R. Anal stenosis. Surg Clin North Am. 2010;90:137–45.CrossRefGoogle Scholar
  8. 8.
    Brochard C, Siproudhis L, Wallenhorst T, Cuen D, d’Halluin PN, Garros A, Bretagne JF, Bouguen G. Anorectal stricture in 102 patients with Crohn’s disease: natural history in the era of biologics. Aliment Pharmacol Ther. 2014;40(7):796–803.CrossRefGoogle Scholar
  9. 9.
    Shawki S, Costedio M. Anal fissure and stenosis. Gastroenterol Clin N Am. 2013;42:729–58.CrossRefGoogle Scholar
  10. 10.
    Bristinda G, Vanella S, Cadeddu F, Marniga G, Mazzeo P, Brandara F, et al. Surgical treatment of anal stenosis. World J Gastroenterol: WJG. 2009;15(16):1921.CrossRefGoogle Scholar
  11. 11.
    Duieb Z, Appu S, Hung K, Nguyen H. Anal stenosis: use of an algorithm to provide a tension-free anoplasty. ANZ J Surg. 2010;80:337–40.CrossRefGoogle Scholar
  12. 12.
    Asfar S. Anoplasty for post-hemorrhoidectomy low anal stenosis: a new technique. World J Surg. 2018 Sep;42(9):3015–20.CrossRefGoogle Scholar
  13. 13.
    Eu KW, Teoh TA, Seow-Choen F, Goh HS. Anal stricture following haemorrhoidectomy: early diagnosis and treatment. Aust N Z J Surg. 1995;65:101–3.CrossRefGoogle Scholar
  14. 14.
    Gülen M, Leventoğlu S, Ege B, Menteş BB. Surgical treatment of anal stenosis with diamond flap anoplasty performed in a calibrated fashion. Dis Colon Rectum. 2016;59(3):230–5.CrossRefGoogle Scholar
  15. 15.
    Farid M, Youssef M, El Nakeeb A, Fikry A, El Awady S, Morshed M. Comparative study of the house advancement flap, rhomboid flap, and y-v anoplasty in treatment of anal stenosis: a prospective randomized study. Dis Colon Rectum. 2010;53(5):790–7.CrossRefGoogle Scholar
  16. 16.
    Sloane J, Zahid A, Young C. Rhomboid-shaped advancement flap anoplasty to treat anal stenosis. Tech Coloproctol. 2017;21(2):159–61.CrossRefGoogle Scholar
  17. 17.
    Casadesus D, Villasana LE, Diaz H, et al. Treatment of anal stenosis: a 5-year review. ANZ J Surg. 2007;77:557–9.CrossRefGoogle Scholar
  18. 18.
    Rakhmanine M, Rosen L, Khubchandani I, Stasik J, Riether R. Lateral mucosal advancement anoplasty for anal stricture. BJS. 2002;89:1423–4.CrossRefGoogle Scholar
  19. 19.
    Maria G, Brisinda G, Civello IM. Anoplasty for the treatment of anal stenosis. Am J Surg. 1998;175:158–60.CrossRefGoogle Scholar
  20. 20.
    Angelchik PD, Harms BA, Starling JR. Repair of anal stricture and mucosal ectropion with YV or pedicle flap anoplasty. Am J Surg. 1993;166:55–9.CrossRefGoogle Scholar
  21. 21.
    Aitola P, Hiltunen K, Matikainen M. YV anoplasty combined with internal sphincterotomy for stenosis of the anal canal. Eur J Surg Acta Chir. 1997;163:839–42.Google Scholar
  22. 22.
    Gingold B, Arvanitis M. YV anoplasty for treatment of anal stricture. Surg Gynecol Obstet. 1986;162:241–2.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Colorectal Division, Department of SurgeryHansol HospitalSeoulSouth Korea

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