RSS-Feed abonnieren

DOI: 10.1055/s-0045-1810615
Outcomes of V-Y Anoplasty Technique in The Management of Moderate to Sever Post Hemorrhoidectomy Anal Stenosis
Authors
Funding The author(s) received no financial support for the research.

Abstract
Introduction
Anal stenosis is a very annoying complication after anorectal surgery. Moderate and severe cases often need surgery.
Objectives
The aim of the study is to evaluate the efficacy and outcomes of an anoplasty technique (V-Y advancement flap) for management of moderate to severe post- hemorrhoidectomy anal stenosis.
Methods
This is a randomized clinical study that was performed on 25 patients with post- hemorrhoidectomy anal stenosis and treated with anoplasty (V-Y advancement flaps) technique in the department of general surgery in a well specialized center from December 2023 to December 2024. Patients were monitored for Pain levels scoring and postoperative complications were analyzed.
Results
The mean age of the study contributors was 36.4 ± 5.25. The gender distribution showed a higher number of males (16) as compared to females (9). 5 patients had severe anal stenosis, while 20 patients had moderate anal stenosis. Mean preoperative VAS score was 6.2 ± 1.4. Follow up at 1, 3 and 6 months showed decrease in VAS score with significant improvement of symptoms. As regards post-operative complications, there was only one patient (4.0%) who presented with postoperative mild bleeding, also one patient (4.0%) suffered from urine retention, two patients (8.0%) had wound dehiscence, one patient (4.0%) patient presented by transient gas incontinence and one patient (4.0%) presented by mild restenosis.
Conclusion
V-Y flap anoplasty is a safe, simple and effective procedure for management of moderate and severe post-hemorrhoidectomy anal stenosis with marked improvement of patient symptoms and low complication rates.
Recommendations
We recommend a long-term prospective study to prove the role of the V-Y flap anoplasty in anal stenosis surgery outcomes.
IRB approval ID: 11393-17-12-2023.
Clinical trial registration ID: NCT06860906 at ClinicalTrials.gov.
Authors' Contributions
RZ: study conception and design, material preparation, data collection and analysis, writing – original draft; AMM: material preparation, data collection; YHH: study conception and design; YAO: study conception and design, material preparation, data collection, data analysis. All authors read and approved the final manuscript.
Data Availability Statement
The data that support the findings of this study are available from the authors upon reasonable request.
ORCID IDs
Reham Zakaria – https://orcid.org/0000-0002-3708-5840
Abd-Elrahman M. Metwalli – https://orcid.org/0009-0006-6325-8959
Yasmine Hany Hegab – https://orcid.org/0009-0003-3433-755X
Yasser A. Orban – https://orcid.org/0009-0008-1343-7275
Publikationsverlauf
Eingereicht: 08. April 2025
Angenommen: 16. Juli 2025
Artikel online veröffentlicht:
07. Oktober 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Reham Zakaria, Abd-Elrahman M. Metwalli, Yasmine Hany Hegab, Yasser A. Orban. Outcomes of V-Y Anoplasty Technique in The Management of Moderate to Sever Post Hemorrhoidectomy Anal Stenosis. Journal of Coloproctology 2025; 45: s00451810615.
DOI: 10.1055/s-0045-1810615
-
References
- 1 Darwish AA, Kamel KA, Eskandaros MS. Diamond Versus V-Y Advancement Flaps for Management of Anal Stenosis: Efficacy and Outcomes. Surg Gastroenterol Oncol 2022; 27 (01) 37-42
- 2 Tahamtan M, Ghahramani L, Khazraei H. et al. Surgical management of anal stenosis: anoplasty with or without sphincterotomy. J Coloproctol (Rio J) 2017 37. 01 https://doi.org/10.1016/j.jcol.2016.06.002
- 3 Chiarelli M, Guttadauro A, Maternini M. et al. The clinical and therapeutic approach to anal stenosis. Ann Ital Chir 2018; 89: 237-241
- 4 Lefta MJ, Baqir QK. DIAMOND FLAP ANOPLASTY FOR SEVERE ANAL STENOSIS. Basrah J Surg 2013; 19 (02) 23-25 https://doi.org/10.33762/bsurg.2013.81515
- 5 Asfar S. Anoplasty for Post-hemorrhoidectomy Low Anal Stenosis: A New Technique. World J Surg 2018; 42 (09) 3015-3020
- 6 Milsom JW, Mazier WP. Classification and management of postsurgical anal stenosis. Surg Gynecol Obstet 1986; 163 (01) 60-64
- 7 Gallo G, Picciariello A, Di Tanna GL. et al. Anoplasty for anatomical anal stenosis: systematic review of complications and recurrences. Colorectal Dis 2022; 24 (12) 1462-1471 wileyonlinelibrary.com/journal/codi https://doi.org/10.1111/codi.16248
- 8 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 (05) 337-340
- 9 Brisinda G. How to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ 2000; 321 (7261): 582-583
- 10 Khanna AK, Khanna S. Bilateral Advancement Heart-Shaped Anoplasty for Severe Anal Stenosis: A New technique. International Journal of Recent Surgical and Medical Sciences 2021; 7(1): 13-16
- 11 Brisinda G, Brandara F, Cadeddu F, Civello IM, Maria G. Hemorrhoids and hemorrhoidectomies. Gastroenterology 2004; 127 (03) 1017-1018
- 12 Brisinda G, Vanella S, Cadeddu F. et al. Surgical treatment of anal stenosis. World J Gastroenterol 2009; 15 (16) 1921-1928
- 13 Maria G, Brisinda G, Civello IM. Anoplasty for the treatment of anal stenosis. Am J Surg 1998; 175 (02) 158-160
- 14 Alver O, Ersoy YE, Aydemir I. et al. Use of “house” advancement flap in anorectal diseases. World J Surg 2008; 32 (10) 2281-2286
- 15 Casadesus D, Villasana LE, Diaz H. et al. Treatment of anal stenosis: a 5-year review. ANZ J Surg 2007; 77 (07) 557-559
- 16 Capdevila X, Aveline C, Delaunay L. et al. Factors determining the choice of spinal versus general anesthesia in patients undergoing ambulatory surgery: results of a multicenter observational study. Adv Ther 2020; 37 (01) 527-540
- 17 Yabanoğlu H. Outcomes of Advancement Flaps Used in the Treatment of Anal Stenosis Developing After Hemorrhoid Surgery: One Center Experience. Turk J Colorectal Dis 2018; 28 (03) 125-128
- 18 Omar Waleed. REPAIR OF ANAL STENOSIS: Y-V OR DIAMOND PEDICLE FLAP ANOPLASTY (COMPARATIVE RANDOMIZED STUDY. Mansoura Med J 2005 34. 2 : Article 7. Available at: https://doi.org/10.21608/mjmu.2005.128243
- 19 Carditello A, Milone A, Stilo F, Mollo F, Basile M. Il trattamento chirurgico delle stenosi anali post-emorroidectomia. Risultati di 150 interventi di anoplastica per scorrimento mucoso e sfinterotomia interna. [Surgical treatment of anal stenosis following hemorrhoid surgery. Results of 150 combined mucosal advancement and internal sphincterotomy] Chir Ital 2002; 54 (06) 841-844 . Italian