Abstract
Purpose
Total intersphincteric resection (total ISR) is a surgical option for patients with advanced cancer of the lower rectum. However, anorectal stricture can develop after total ISR, which stretches from the anus to the lower rectum. Conventional anoplasty for anal stricture is often ineffective for them because the areas of stricture are long and the most proximal points of the strictures are too far for advancement flaps or rotation flaps to reach. We have developed a new surgical treatment method using a gluteal-fold flap (GFF) for anal stricture after total ISR.
Methods
From April 2004 through June 2007, hemilateral GFFs were transferred to treat anorectal strictures after total ISR in three patients at the National Cancer Center Hospital East, Chiba, Japan. Postoperative results and anal function were evaluated.
Results
In all three patients, GFFs were successfully transferred, and good dilation of the anorectal stenosis was achieved. Postoperative anal function was satisfactory.
Conclusion
The GFF has a rich vascular supply and can be simply and reliably transferred. We believe that GFF transfer is an excellent option for treating anorectal strictures after total ISR.
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Acknowledgment
This work is supported by the National Cancer Center Hospital East.
Conflict of interest
The authors declare that they have no proprietary, financial, professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in this manuscript.
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Tsuchiya, S., Sakuraba, M., Asano, T. et al. New application of the gluteal-fold flap for the treatment of anorectal stricture. Int J Colorectal Dis 26, 653–659 (2011). https://doi.org/10.1007/s00384-010-1115-2
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DOI: https://doi.org/10.1007/s00384-010-1115-2