Assessment of the Heineke–Mikulicz anoplasty for skin level postoperative anal strictures and congenital anal stenosis
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In brief
In brief
This retrospective study of 28 patients demonstrates that Heineke-Mikulicz anoplasty is an effective outpatient procedure for managing skin-level anal strictures following posterior sagittal anorectoplasty and congenital anal stenosis. The technique achieved significant anal caliber improvement, increasing from Hegar 8 to 16, with minimal complications over one-year follow-up.
Written by the GCMD Library team from the article.
Introduction
Acquired skin-level strictures following posterior sagittal anorectoplasty (PSARP) and some rare cases of congenital anal stenosis can be managed using a Heineke–Mikulicz like anoplasty (HMA). We hypothesized that this procedure was an effective, safe, and durable outpatient procedure in select patients.
Methods
We retrospectively reviewed all patients who underwent HMA for skin level strictures following PSARP or for certain congenital anal stenoses from 2014 to 2017.
Results
Twenty-eight patients (19 males, 9 females) with a mean age of 5.8 years (range 0.5–24.4) underwent HMA. Twenty-six had a prior PSARP, of which 18 were redo, and 8 were primary procedures. Two patients had congenital skin level anal stenosis. The mean follow up was 1.0 years (range 0.4–2.9). The average preprocedure anal size was Hegar 8, which after HMA increased 8 Hegar sizes to 16 (95% CI 7–9, p