Annals of Coloproctology

Benign proctology

Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence: Adeodatus Yuda Handaya, Aditya Rifqi Fauzi; Ann Coloproctol. 2020;36(2):122-127. Published online March 17, 2020; DOI: https://doi.org/10.3393/ac.2018.11.19

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The ideal intervention in the treatment of perianal fistula prevents the onset of infection to speed healing and prevent fistula recurrence while maintaining the function of the anal sphincter. Currently, there is no consensus on the best recommended surgical technique for perianal fistula management. Several studies have shown that fistulotomy was an easy and safe procedure for treatment of perianal fistula. Lateral internal sphincterotomy is the usual procedure performed on an anal fissure to decrease the anal sphincter tone. This study reports a combination of fistulotomy and contralateral internal sphincterotomy procedures for recurrent and complex perianal fistula to prevent recurrence. Here, we report 5 cases of recurrent and complex perianal fistula. The combination of fistulotomy and contralateral internal sphincterotomy is a relatively easy and safe procedure for complex perianal fistulae. In our cases, we found neither recurrence nor postoperative anal incontinence.

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Modified anal sphincter suspension improves anal function in patients with anal fistula
Peng Chen
American Journal of Translational Research.2024; 16(9): 4858. CrossRef
Ligation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for High-Type Fistula in Ano: A Randomized Controlled Trial
Pankaj Kumar, Siddhant Sarthak, Pradeep K Singh, Tushar S Mishra, Prakash K Sasmal
Journal of the American College of Surgeons.2023; 236(1): 27. CrossRef
Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub] CrossRef

Benign GI diease

Double Pedicle Artery Rotation Sigmoid Vaginoplasty for Vaginal Aplasia Management: Adeodatus Yuda Handaya, Nurcahya Setyawan, Nuring Pangastuti, Marijata , Agus Barmawi, Imam Sofii, Muhamad Nurhadi Rahman, Ida Ayu Setyawati, Hamzah Muhammad Hafiq; Ann Coloproctol. 2020;36(3):198-203. Published online January 20, 2020; DOI: https://doi.org/10.3393/ac.2018.10.30

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Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.

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Defining and measuring acceptability of surgical interventions: A scoping review
Sophie James, Jennie Lister, Joy Adamson, Catherine Hewitt, Antonina Yakimova, Andrew Mott, Helen Fulbright, Catriona McDaid, Federico Romano
PLOS One.2025; 20(6): e0323738. CrossRef

Bilateral Rotational S Flap Technique for Preventing Restenosis in Patients With Severe Circular Anal Stenosis: A Review of 2 Cases: Yuda Handaya, Mukhamad Sunardi; Ann Coloproctol. 2019;35(4):221-224. Published online February 19, 2019; DOI: https://doi.org/10.3393/ac.2017.10.16

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Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techniques are used for treatment severe anal stenosis, such as the C flap, House flap, U flap, and rotational S flap, but no procedure is ideal for every patient. We review 2 cases of severe circular anal stenosis. Their complaints included narrow caliber of the stool and feeling unsatisfied defecation. Excision of scar tissue using the circular technique was followed by reconstruction using the bilateral rotational S flap procedure. At the 1-year follow-up, the patient had complaints about neither defecation nor pain, and no longer needed laxative agents. In conclusion, the bilateral rotational S flap technique should be considered as a viable treatment because it can also prevent the occurrence of restenosis, especially given the consideration of adequate blood supply.

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Is anoplasty superior to scar revision surgery for post-hemorrhoidectomy anal stenosis? Six years of experience
Yu-Tse Weng, Kuan-Jung Chu, Kuan-Hsun Lin, Chun-Kai Chang, Jung-Cheng Kang, Chao-Yang Chen, Je-Ming Hu, Ta-Wei Pu
World Journal of Clinical Cases.2022; 10(22): 7698. CrossRef
Anoplasty for anatomical anal stenosis: systematic review of complications and recurrences
Gaetano Gallo, Arcangelo Picciariello, Gian Luca Di Tanna, Patrizia Pelizzo, Donato Francesco Altomare, Mario Trompetto, Giulio Aniello Santoro, Franco Roviello, Carla Felice, Ugo Grossi
Colorectal Disease.2022; 24(12): 1462. CrossRef

Abdominosacral Resection in the Management of Large-Size Retrorectal Tumors: A Report of 2 Rare Cases: Yuda Handaya, Sutamto Wibowo; Ann Coloproctol. 2018;34(5):271-276. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2017.12.01

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Abstract PDF: Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.

Side-to-Side Ileosigmoidostomy Shunting Surgery for the Treatment of Elderly Patients With Chronic Constipation: Yuda Handaya, Agung Maryanto, Marijata; Ann Coloproctol. 2017;33(6):249-252. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.249

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Abstract PDF: Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic constipation (slow transit constipation) and treated with conventional therapy, but did not improve. For that reason, side-to-side ileosigmoidostomy shunting surgery was performed. After the surgery, the average time until normal defecation was 16 days, and the defecation frequency was 3 to 4 times a day with no need for a laxative. No patient had a recurrence of constipation. Based on these results, side-to-side ileosigmoidostomy shunting surgery is expected to restore digestive function and can be considered as an alternative therapy for elderly patients with chronic constipation.

Ileocolonic Transposition Esophagogastric Bypass as an Antireflux Treatment for Corrosive Esophageal Injury: Yuda Handaya, Mukhamad Sunardi; Ann Coloproctol. 2017;33(4):150-155. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.150

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Because most surgeons perform an esophagectomy and colonic transposition as the main reconstruction method for patients with esophageal stenosis caused by swallowing corrosive materials, we report 2 cases in which ileocolonic transposition was used to treat such patients. Both patients displayed stenosis in the middle third of the esophagus. Their chief complaint was dysphagia. Ileocolonic transposition using vascularization of the Drummond and ileal arteries was followed by a prepared ileocolic graft by ligating ileocolic vessels. We performed an ileocolonic transposition esophagogastric bypass without an esophagectomy. All surgeries resulted in minimal intraoperative bleeding. Patients experienced no leakage, postoperative fistulas, dysphagia, or postoperative reflux. Three weeks after surgery, 1 patient experienced reversible hoarseness caused by extensive laryngeal-nerve manipulation. Cumulatively, ileocolonic transposition with cervical anastomosis for the treatment of patients with esophageal stenosis caused by corrosive esophageal injury can be considered to be an antireflux treatment because the ileocaecal sphincter is maintained.

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HYPERBARIC OXYGEN THERAPY AS AN ADJUVANT TREATMENT IN HYDROCHLORIC ACID POISONING: A LITERATURE REVIEW
Desi Rahmah Sari, Ismi Dian Meiliana, Dewangga Satria Sakti Kinasih, Hamidah Kurniasari, Purwo Sri Rejeki
Majalah Biomorfologi.2023; 33(1): 52. CrossRef

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