Document Detail


Comparative study of the house advancement flap, rhomboid flap, and y-v anoplasty in treatment of anal stenosis: a prospective randomized study.
MedLine Citation:
PMID:  20389213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Anal stenosis represents a technical challenge for surgical management. We compared the effects of house flap, rhomboid flap, and Y-V anoplasty procedures in a randomized study in patients with anal stenosis. METHODS: Consecutive patients treated for anal stenosis at our institution were evaluated for inclusion. Participants were randomly allocated to receive house flap, rhomboid flap, or Y-V anoplasty. Follow-up visits were after 1 week, 1 month, 6 months, and 1 year. Study variables included caliber of the anal canal (measured with a conical calibrator), clinical improvement, patient satisfaction (visual analog scale), incontinence (Pescatori incontinence scale), and quality of life (GI Quality of Life Inventory). RESULTS:: Sixty patients with anal stenosis were randomized and completed the study. Operative time was 62 +/- 10 minutes for house flap, 44 +/- 13 minutes for rhomboid flap, and 35 +/- 9 minutes for Y-V anoplasty (P = .042). At 1 year, anal caliber was 23.9 +/- 2.33 mm for house flap, 18.1 +/- 2.05 mm for rhomboid flap, and 16.4 +/- 2.05 mm for Y-V anoplasty (P = .04), with a highly significant increase for the house flap (P = .001). The groups differed significantly regarding clinical improvement at 1 month (95% for house flap, 80% for rhomboid flap, and 65% for Y-V anoplasty, P = .01) and differences persisted at 1 year. Significant differences were seen among groups at 1 year in GI Quality of Life Inventory scores (P = .03), with significant improvement only for the house flap (P = .01). CONCLUSION: Anal stenosis can be effectively managed with the house flap procedure, with the sole disadvantage of longer operative time. Although all 3 procedures are simple and easy to perform, the house flap appears to produce the greatest clinical improvement, patient satisfaction, and improvement in quality of life, with the fewest complications.
Authors:
Mohamed Farid; Mohamed Youssef; Ayman El Nakeeb; Amir Fikry; Saleh El Awady; Mosaad Morshed
Related Documents :
16809913 - Combined thiersch's procedure and subanodermal coagulation for complete rectal prolapse...
11129813 - Functional results of delayed coloanal anastomosis after preoperative radiotherapy for ...
12854053 - Ocular surface changes in keratoconjunctivitis sicca with silicone punctum plug occlusion.
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  53     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-14     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  790-7     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Colorectal Surgery Unit, Mansoura University, Mansoura, Egypt.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anus Diseases / surgery*
Constriction, Pathologic / surgery
Female
Humans
Male
Middle Aged
Patient Satisfaction
Postoperative Complications
Prospective Studies
Quality of Life
Surgical Flaps*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Prediction of residual disease or distant metastasis after resection of locally recurrent rectal can...
Next Document:  Long-term outcomes with the use of bioprosthetic plugs for the management of complex anal fistulas.