Surgical management of anal stenosis following hemorrhoid treatment: a single-center case series

OBJECTIVE: To describe the clinical characteristics, causes, classification, and surgical techniques used to treat anal stenosis following hemorrhoid surgery, as well as to evaluate the treatment outcomes based on specific clinical criteria. SUBJECTS AND METHODS: This retrospective case series included 13 patients with anal stenosis after hemorrhoidectomy. All underwent surgical treatment at Viet Duc University Hospital between January 2022 and June 2024. Surgical techniques applied were fibrotic ring release alone, fibrotic ring release with rectal mucosal advancement, fibrotic ring release with horizontal suturing of the rectal mucosa, and fibrotic ring release with V-Y flap reconstruction. Outcomes were assessed based on patients' ability to achieve normal defecation, stool caliber, and the absence of anal pain or bleeding postoperatively. Successful treatment was defined as normalized stool passage without pain or the need for stool softeners. RESULTS: Surgical outcomes were favorable in 12 out of 13 patients (92.3%), with an average healing time of 2.0 ± 1.1 months. The mean follow-up was 13.3 months (range 6-24 months; minimum 6 months). Patients treated with fibrotic ring release alone experienced the longest healing time, while those who underwent mucosal advancement or V-Y flap reconstruction had shorter recovery periods. Recurrence occurred in one patient who required reoperation. CONCLUSION: Anal stenosis is a rare but serious complication following hemorrhoid surgery. Surgical interventions, including fibrotic ring release and anoplasty, appeared to be effective and safe, with favorable short-term outcomes in most patients.