Anoplasty for the treatment of anal stenosis

BACKGROUND: Cicatricial stenosis of the anal canal is a disabling complication of anal surgery. Many different surgical techniques have been described for the management of this disorder. METHODS: In this study we report 42 patients with severe anal stricture treated with anoplasty. Twenty- nine of these patients underwent a Y-V anoplasty while 13 had a diamond flap anoplasty. All patients were seen 4 weeks, 6 months, and 2 years after surgery. RESULTS: Three patients who had undergone Y-V anoplasty experienced, as a minor early operative complication, a suture dehiscence and 1 patient had an ischemic contracture of the leading edge of the flap. Two patients had urinary infections. None of these complications needed further surgical intervention and were all managed with local and medical therapy. At 2 years follow-up 93% of patients had been successfully treated while the remaining 7% had improved. Fifteen percent of patients who had undergone Y-V anoplasty complained of postoperative complications, and all patients with incomplete results had been treated with an Y-V anoplasty. CONCLUSIONS: Based on our cohort of patients we believe that both techniques are satisfactory in treating anal stricture but diamond flap anoplasty seems more reliable because of the reduced tension at the suture line and the better blood supply to the flap.