Evaluation of Diamond Flap Anoplasty for Treatment of Post Haemorrhoidectomy Anal Stenosis

Background: Anal stenosis is an anatomical narrowing of the anal canal and can be caused by excisional haemorrhoidectomy, radiation therapy, congenital malformation, and inflammatory bowel disease (Crohn’s and ulcerative colitis), tuberculosis, venereal diseases.Aim of the Work: To evaluate the outcome of Diamond flap Anoplasty for management of Post Haemorrhoidectomy Anal stenosis as regard intraoperative, postoperative complications and recurrence.Patients and Methods: This retrospective cohort study, conducted in accordance with the STROCSS guideline (Strengthening the Reporting of Cohort Studies in Surgery), aims to evaluate 20 patients with anal stenosis following haemorrhoidectomy who presented at Ain Shams University hospitals. The study will utilize available data from pre-operative, operative, and post-operative records, with patients being followed up for final outcomes. Data collection will take place from October 2024 to March 2025, focusing on patients who underwent surgery between January 2021 and January 2024.Results: Preoperatively, patients with anal stenosis experienced significant symptoms, including constipation (60%) and difficulty with evacuation (50%), severely affecting quality of life. Postoperative outcomes showed marked improvement, with constipation and evacuation issues reduced to 15% and 10%, respectively (p < 0.05), without added complications. Anal caliber significantly increased from 10.5 mm to 24.4 mm (p < 0.001), supporting anatomical success. Recovery was smooth, with a 1-day hospital stay, 56-minute operative time, and 10-week healing. Pain declined steadily, and patient satisfaction rose from 5.7 to 9.6 over six months. The flap technique proved safe, effective, and associated with high patient satisfaction.Conclusion: Diamond flap anoplasty has proven to be a safe, effective, and well-tolerated surgical technique for the treatment of moderate to severe post-haemorrhoidectomy anal stenosis. The procedure resulted in significant improvement in anal caliber, marked reduction in symptoms such as constipation and evacuation difficulty, and minimal postoperative complications, with no cases of flap necrosis and a low restenosis rate.