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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Is anoplasty superior to scar revision surgery for post-hemorrhoidectomy anal stenosis? Six years of experience
Yu-Tse Weng, Kuan-Jung Chu, Kuan-Hsun Lin, Chun-Kai Chang, Jung-Cheng Kang, Chao-Yang Chen, Je-Ming Hu, Ta-Wei Pu
Yu-Tse Weng, Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Kuan-Jung Chu, National Defense Medical Center, Taipei 114, Taiwan
Kuan-Hsun Lin, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Chun-Kai Chang, Division of Plastic and Reconstructive Surgery, Department of Surgery, Zuoying Branch, Kaohsiung Armed Forces General Hospital, Kaohsiung 813, Taiwan
Jung-Cheng Kang, Division of Colon and Rectal Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei 105, Taiwan
Chao-Yang Chen, Je-Ming Hu, Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Ta-Wei Pu, Division of Colon and Rectal Surgery, Department of Surgery, Songshan branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 105, Taiwan
Author contributions: Weng YT contributed to this work; Weng YT, Jung CK, Lin KH, Chang CK, Kang JC, Chen CY, Hu JM, and Pu TW designed the research study; Weng YT, Jung CK and Pu TW performed the research; Weng YT and Lin KH contributed new reagents and analytic tools; Weng YT, Jung CK, Lin KH and Pu TW analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Taiwan Adventist Hospital Institutional Review Board, Approval No. 111-E-01.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ta-Wei Pu, MD, Doctor, Lecturer, Division of Colon and Rectal Surgery, Department of Surgery, Songshan branch, Tri-Service General Hospital, National Defense Medical Center, No. 131 Jiankang Road, Taipei 105, Taiwan. tawei0131@gmail.com
Received: February 16, 2022
Peer-review started: February 16, 2022
First decision: April 16, 2022
Revised: April 19, 2022
Accepted: June 26, 2022
Article in press: June 26, 2022
Published online: August 6, 2022
ARTICLE HIGHLIGHTS
Research background
There are two main surgical treatments for anal stenosis: scar revision surgery and anoplasty. There were no studies comparing these two approaches, and it remains unclear which is preferrable for stenoses of different severities, including mild, moderate, and severe.
Research motivation
To compare the outcomes of scar revision surgery and double diamond-shaped flap anoplasty for anal stenosis.
Research objectives
To analyze which surgery have benefit to different severity of anal stenosis.
Research methods
Patients with anal stenosis following hemorrhoidectomy procedures who were treated with either scar revision surgery or double diamond-shaped flap anoplasty at our institution between January 2010 and December 2015 were investigated and compared.
Research results
The mean operative time for scar revision surgery was significantly shorter than that for double diamond-shaped flap anoplasty. The average of length of hospital stay was also significantly shorter after scar revision surgery than after anoplasty.
Research conclusions
Scar revision surgery may be preferable for mild anal stenosis upon conservative treatment failure. Anoplasty is unavoidable for moderate or severe stenosis, where cicatrized tissue is extensive.
Research perspectives
Further study must conduct to analyze which surgery have benefit to different severity of anal stenosis.
