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CC BY 4.0 · Journal of Coloproctology 2025; 45(03): s00451810615
DOI: 10.1055/s-0045-1810615
Original Article

Outcomes of V-Y Anoplasty Technique in The Management of Moderate to Sever Post Hemorrhoidectomy Anal Stenosis

Authors

  • Reham Zakaria 

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Abd-Elrahman M. Metwalli 

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Yasmine Hany Hegab 

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Yasser A. Orban 

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Funding The author(s) received no financial support for the research.
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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.

Keywords

anal stenosis - anoplasty - V-Y advancement flap

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




Publication History

Received: 08 April 2025

Accepted: 16 July 2025

Article published online:
07 October 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/)

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Bibliographical Record
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