The house advancement anoplasty for treatment of anal disorders

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.

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.

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.

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.