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항문협착증에서 C형 회전피판술과 집모양형(house) 전진피판술의 비교

Comparison of C-anoplasty and House Shaped Advancement Flap in Anal Stenosis

대한대장항문학회지 2001년 17권 2호 p.76 ~ 83
양형규 ( Yang Hyung-Kyu ) - 양병원 대장항문과

김상희 ( Kim Sang-Hee ) - 양병원 대장항문과
류광석 ( Ryu Kwang-Seok ) - 양병원 대장항문과
최재표 ( Choi Jae-Pyo ) - 양병원 대장항문과
나재웅 ( Na Jae-Woong ) - 양병원 대장항문과
반재민 ( Ban Jae-Min ) - 양병원 대장항문과

Abstract


Purpose: The surgical treatment of anal stenosis includes internal sphincterotomy, rotaton flap and advancement flap according to the stenosis degree, recently, Christensen performed house shaped advancement flap and reported fair results. We compared and analyzed the surgical methods and results in patients with moderate and severe anal stenosis who underwent house shaped advancement flap and C-anoplasty.

Methods: We have performed this study with 6 cases using the house shaped advancement flap and 6 cases using the C-anoplasty. The out come was assessed by clinical characteristics, surgical method, operation time, duration of hospitalization, healing time, postoperative complications, results.

Results: The average operation time was 38 min in those house shaped advancement flap cases and 63 min in C-anoplasty cases. The average time of hospitalization was 6 days and 9 days, respectively, and the average time of healing was 28 days and 46 days, respectively. In those house advancement flap cases, surgery could be done in 2 directions at the same time in 4 cases and 3 directions in 2 cases; as for those C-anoplasty cases, surgery could be done in 1 direction in 4 cases and 2 directions in 1 case. Two complications were observed in C-anoplasty, one flap infection and one flap necrosis, and in house shaped advancement flap, no complication was observed.

Conclusion: House shaped advancement flap have several advantages compared to the C-anoplasty, and since house shaped advancement flap could be performed in 2 to 3 directions or even 4 directions at the same time, the anus could sufficiently expanded in severe anal stenosis patients. The house shaped advancement flap might be one of the good method in treating anal stenosis.

키워드

항문협착증;집모양형 전진피판술;C형 회전피판술
Anal stenosis;House shaped advancement flap;C-anoplasty
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