The Comparison of Two Surgical Techniques In The Treatment Of The Anal Stricture Posthemorrhoidectomy Milligan-Morgan

Abstract

Surgical treatment of anal in open posthemorrhoidectomy brings various complications to open hemorrhoidectomy in 5%-10% of cases. In books it is widely known as the fibrotic benign stricture or as iatrogenic Clinically, it is manifested with pain during defecation, minimal rectoragy and abdominal discomfort accompanied with a feeling of not having adequately emptied bowels. Locally, it is manifested in form of a rigid ring where even small finger can hardly be penetrated. These symptoms can severely affect quality of life in patients. Depending on grade of anal canal stricture, we can say that anal is found on three grades: light anal stricture, moderated anal and expressed anal stricture. All our patients resulted in expressed anal stricture. In our research we have compared two operative techniques which were applied for surgical treatment of pathology. Partial posterior internal sphincterotomy technique with anoplastic in open wound (SIPA) and plastic with skin flap and closed internal lateral sphincterotomy, V-Y advancement flap (PLSL). Each technique aims at relaxing anal canal with as less continence damage as possible and faster rehabilitation of patient. The patients were divided into two groups: Group A of 15 patients treated with SIPA technique and Group B of 14 patients treated with PLSL technique. The study was conducted during February 2006 - March 2014. The results favored PLSL technique.