Anal stenosis is a fibrous narrowing of the anal channel. It develops, in most cases, in the aftermath of proctologic surgical procedures with extensive anoderm excision or in the presence of chronic anal inflammation in patients with Crohn Disease. However rare, this condition is thoroughly debilitating for the patients. Symptoms include constipation, pain and bleeding with defecation and a reduction of the caliber of stools. Diagnosis is essentially clinical. Prevention of postsurgical stenosis is based on a scrupulous surgical technique and on an extensive and carefully- planned follow up. Treatment is based on an initially conservative approach with regularization of stool transit through hydration, dietary fibers and bulk-forming laxatives. The role of mechanical dilatation in the treatment of AS is still debated. For severe cases and cases that are not responsive to conservative treatment we must resort to surgery. Surgical approach is tailored on the severity, position and extension. The most severe cases require anoplasty procedures with mucosal or anal flaps. KEY WORDS: Anal stenosis, Anal stricture,Proctology.

La stenosi anale è un restringimento fibroso del canale anale. Si sviluppa, nella maggior parte dei casi, in seguito a procedure chirurgiche proctologiche con ampia escissione anodermica o in presenza di infiammazione anale cronica in pazienti con malattia di Crohn. Per quanto rara, questa condizione è molto debilitante per i pazienti. I sintomi includono stitichezza, dolore e defecazione con anguinamento e una riduzione del calibro delle feci. La diagnosi è essenzialmente clinica. La prevenzione della stenosi post-chirurgica si basa su una scrupolosa tecnica chirurgica e su un follow-up ampio e attentamente pianificato. Il trattamento si basa su un approccio inizialmente conservativo con la regolarizzazione del transito delle feci attraverso l’idratazione, fibre alimentari e lassativi formanti massa. Il ruolo della dilatazione meccanica nel trattamento della stenosi anale è ancora oggetto di discussione. Per i casi gravi che non rispondono al trattamento conservativo si deve ricorrere alla chirurgia. L’approccio chirurgico è adattato alla gravità e all’estensione fino ad arrivare all’anoplastica con flap mucoso.

Chiarelli, M., Guttadauro, A., Maternini, M., Lo Bianco, G., Tagliabue, F., Achilli, P., et al. (2018). The clinical and therapeutic approach to anal stenosis. ANNALI ITALIANI DI CHIRURGIA, 89, 237-241.

The clinical and therapeutic approach to anal stenosis

Guttadauro, Angelo
Secondo
;
Lo Bianco, Giulia;Gabrielli, Francesco
Ultimo
2018

Abstract

Anal stenosis is a fibrous narrowing of the anal channel. It develops, in most cases, in the aftermath of proctologic surgical procedures with extensive anoderm excision or in the presence of chronic anal inflammation in patients with Crohn Disease. However rare, this condition is thoroughly debilitating for the patients. Symptoms include constipation, pain and bleeding with defecation and a reduction of the caliber of stools. Diagnosis is essentially clinical. Prevention of postsurgical stenosis is based on a scrupulous surgical technique and on an extensive and carefully- planned follow up. Treatment is based on an initially conservative approach with regularization of stool transit through hydration, dietary fibers and bulk-forming laxatives. The role of mechanical dilatation in the treatment of AS is still debated. For severe cases and cases that are not responsive to conservative treatment we must resort to surgery. Surgical approach is tailored on the severity, position and extension. The most severe cases require anoplasty procedures with mucosal or anal flaps. KEY WORDS: Anal stenosis, Anal stricture,Proctology.
Articolo in rivista - Articolo scientifico
Anal stenosis, Anal stricture,Proctology
English
2018
89
237
241
reserved
Chiarelli, M., Guttadauro, A., Maternini, M., Lo Bianco, G., Tagliabue, F., Achilli, P., et al. (2018). The clinical and therapeutic approach to anal stenosis. ANNALI ITALIANI DI CHIRURGIA, 89, 237-241.
File in questo prodotto:
File Dimensione Formato  
The clinical and therapeutic approach to anal stenosis.pdf

Solo gestori archivio

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 504.55 kB
Formato Adobe PDF
504.55 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/219650
Citazioni
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 9
Social impact