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The House Advancement Anoplasty for Treatment of Anal Disorders.
  1. Miss Harriet A. Owen, MRCS1,
  2. Lt Col David P. Edwards, ChM FRCSEd (Gen Surg) RAMC MDHU2,
  3. Mr Kourosh Khosraviani, FRCSEd (Gen Surg)3 and
  4. Prof Robin K.S. Phillips, MS FRCS4
  1. 1St. Marks Hospital, Watford Road, Harrow, London HA1 3UJ
  2. 2Frimley Park Hospital, Portsmouth Road, Frimley, Surrey GU16 7UJ
  3. 3Belfast Institute of Clinical Science Royal Group of Hospitals, Grosvenor Road, Belfast BT12 6BJ
  4. 4St. Marks Hospital, Watford Road, Harrow, London HA1 3UJ

Abstract

Objectives Anal advancement flaps treat a variety of anal disorders. In recent years the “House” advancement flap has been used with good success, the term referring to the shape of the flap used. It is simple with few shortcomings. We reviewed a single centre’s experience of this procedure.

Methods All patients who underwent a house advancement flap between 1996 and 2001 were identified. The case notes were examined and data collected on indication for surgery, complications, follow-up and outcome.

Results Thirteen consecutive patients were identified, mean age of 44 years. Indications for surgery were chronic anal fissure, fistulous disease and post surgical deformity or stenosis of the anal canal. Median follow-up was 37 months (25-84). In 9 patients the flaps healed within 4 weeks. In the remaining 4 patients the flaps healed by secondary intention over a median of 14 weeks (8-20). Postoperative complications occurred in 5 patients (3 donor site separation and 2 flap retraction). Two patients developed recurrence of their original disorder. Eleven patients have relief of pre-operative symptoms with fully healed flaps.

Conclusion This procedure is simple, easy to construct and robust. It can be performed for a variety of anal disorders with satisfactory results and few complications and should be in every Coloproctologist’s armamentarium.

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