The Experts below are selected from a list of 117 Experts worldwide ranked by ideXlab platform

James R. Starling - One of the best experts on this subject based on the ideXlab platform.

  • repair of Anal Stricture and mucosal ectropion with y v or pedicle flap anoplasty
    American Journal of Surgery, 1993
    Co-Authors: Paul D Angelchik, Bruce A Harms, James R. Starling
    Abstract:

    Cicatricial stenosis and mucosal ectropion of the Anal cAnal are disabling complications of Anal surgery or disease and are extremely difficult to manage. Perusal of the literature reveals minimal consensus as to the most successful way to surgically manage patients with these conditions. During a 4-year period, we managed 19 patients who had Anal stenosis (n=14) or Anal ectropion (n=5). Eighteen of these patients had prior Anal rectal surgery. We employed a Y-V anoplasty or advancement diamond-shaped pedicle flap and obtained satisfactory to excellent results in all patients. Concurrent lateral internal sphincterotomy was also employed in selected patients who had a fibrotic muscular component contributing to the stenosis. Based on our cohort of patients, we believe the pedicle skin flap technique is slightly superior to the Y-V anoplasty in functional and cosmetic results.

Paul D Angelchik - One of the best experts on this subject based on the ideXlab platform.

  • repair of Anal Stricture and mucosal ectropion with y v or pedicle flap anoplasty
    American Journal of Surgery, 1993
    Co-Authors: Paul D Angelchik, Bruce A Harms, James R. Starling
    Abstract:

    Cicatricial stenosis and mucosal ectropion of the Anal cAnal are disabling complications of Anal surgery or disease and are extremely difficult to manage. Perusal of the literature reveals minimal consensus as to the most successful way to surgically manage patients with these conditions. During a 4-year period, we managed 19 patients who had Anal stenosis (n=14) or Anal ectropion (n=5). Eighteen of these patients had prior Anal rectal surgery. We employed a Y-V anoplasty or advancement diamond-shaped pedicle flap and obtained satisfactory to excellent results in all patients. Concurrent lateral internal sphincterotomy was also employed in selected patients who had a fibrotic muscular component contributing to the stenosis. Based on our cohort of patients, we believe the pedicle skin flap technique is slightly superior to the Y-V anoplasty in functional and cosmetic results.

Nicola Armenise - One of the best experts on this subject based on the ideXlab platform.

  • giant fecaloma in an adult with severe Anal Stricture caused by Anal imperforation treated by proctocolectomy and ileostomy report of a case
    Diseases of The Colon & Rectum, 2009
    Co-Authors: D F Altomare, M Rinaldi, P L Sallustio, Nicola Armenise
    Abstract:

    Although fecalomas are relatively common in patients who are elderly, constipated, or who have spinal injuries, a giant fecaloma formation unresponsive to conservative treatment is a rare condition that sometimes requires surgery for complications. Herein we report a case of a long-lasting (46 years) giant fecaloma associated with severe Anal Stricture after surgery for Anal atresia and resulting in severe malnutrition, bone structural changes, and severe impairment of quality of life. Eight months after treatment by total proctocolectomy and ileostomy, the patient was on a free diet and had gained more than 10 percent of his postoperative body weight; improvements were observed in the tone of the abdominal muscles and in his quality of life.

Ignazio Massimo Civello - One of the best experts on this subject based on the ideXlab platform.

  • anoplasty for the treatment of Anal stenosis
    American Journal of Surgery, 1998
    Co-Authors: Giorgio Maria, Giuseppe Brisinda, Ignazio Massimo Civello
    Abstract:

    BACKGROUND: Cicatricial stenosis of the Anal cAnal is a disabling complication of Anal surgery. Many different surgical techniques have been described for the management of this disorder. METHODS: In this study we report 42 patients with severe Anal Stricture treated with anoplasty. Twenty-nine of these patients underwent a Y-V anoplasty while 13 had a diamond flap anoplasty. All patients were seen 4 weeks, 6 months, and 2 years after surgery. RESULTS: Three patients who had undergone Y-V anoplasty experienced, as a minor early operative complication, a suture dehiscence and 1 patient had an ischemic contracture of the leading edge of the flap. Two patients had urinary infections. None of these complications needed further surgical intervention and were all managed with local and medical therapy. At 2 years follow-up 93% of patients had been successfully treated while the remaining 7% had improved. Fifteen percent of patients who had undergone Y-V anoplasty complained of postoperative complications, and all patients with incomplete results had been treated with an Y-V anoplasty. CONCLUSIONS: Based on our cohort of patients we believe that both techniques are satisfactory in treating Anal Stricture but diamond flap anoplasty seems more reliable because of the reduced tension at the suture line and the better blood supply to the flap.

Randolph M Steinhagen - One of the best experts on this subject based on the ideXlab platform.

  • Anal fissure 20 year experience
    Diseases of The Colon & Rectum, 1995
    Co-Authors: Changyul Oh, Celia M Divino, Randolph M Steinhagen
    Abstract:

    PURPOSE: This study was designed to review a 20-year experience of the treatment of patients with Anal fissure to identify possible etiologic factors and to explore effective preventative measures and the ideal treatment for this disease. METHODS: From January 1972 to December 1991, 1,391 patients (700 males, 691 females; average age, 39 years) with chronic symptomatic Anal fissures underwent surgical treatment using either open or closed techniques. The following procedures were performed: 1) internal sphincterotomy for 1,313 idiopathic fissures; 2) C-anoplasty for 36 cases of Anal Stricture; 3) debridement and sphincterotomy for 25 patients with postsurgical nonhealing wounds; 4) bilateral excision of the protruding internal sphincter for 17 patients with «subluxation.» Acute superficial Anal fissures were treated conservatively, with emphasis on Anal hygiene. RESUTS: Acute superficial Anal fissures responded well to conservative management. Over 95 percent of patients with chronic Anal fissures treated by surgery had satisfactory relief of symptoms. Early complications included urinary retention (1.4 percent), bleeding (1.1 percent), and abscess and fistula formation (0.7 percent). Late complications manifested as flatus and liquid incontinence (1.5 percent), delayed wound healing (1.4 percent), recurrence of fissures (1.3 percent), and symptomatic itching and burning (1.1 percent). The complication rate was higher in the group that underwent closed sphincterotomy than in the group treated by open techniques. CONCLUSIONS: Proper Anal hygiene is important in both prevention and initial conservative management of symptomatic Anal fissures. For chronic intractable cases, open lateral internal sphincterotomy is strongly recommended. C-anoplasty should be done when Strictures are present. Excision of the protruding internal sphincter is recommended in patients who present with an excessively elongated, tight Anal cAnal with a partially protruding internal sphincter