1/5. The prepuce flap in the reconstruction of male anal stenosis.Circumferential stenosis of the male anal canal was repaired using a subcutaneous prepuce flap. The stenosis was released to create a rhomboid defect. Then, to cover the defect a rectangular flap was designed on the hairless ventral side of the penis. The flap was raised over the Buck's fascia while preserving the subcutaneous vessels in the dartos fascia, which formed the pedicle of the flap. The flap was transposed to the defect by passing it through a tunnel in the perineum. The postoperative course was uneventful and the result was good. The flap had reliable vascularity, was very thin, and pliable so that it could adapt to the rhomboid defect in the anal canal.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/5. Dieulafoy's lesion of the anal canal: a new clinical entity. Report of two cases.Dieulafoy's lesion is an unusual source of massive lower gastrointestinal hemorrhage. It is characterized by severe bleeding from a minute submucosal arteriole that bleeds through a punctate erosion in an otherwise normal mucosa. Although Dieulafoy's lesions were initially described only in the stomach and upper small intestine, they are being identified with increasing frequency in the colon and rectum. To our knowledge, however, Dieulafoy's lesion of the anal canal has not been described previously. We present two patients with Dieulafoy's lesion of the anal canal who presented with sudden onset of massive hemorrhage. The clinicopathologic features of this unusual clinical entity are discussed and suggestions are made for diagnosis and management.- - - - - - - - - - ranking = 3keywords = canal (Clic here for more details about this article) |
3/5. Metastatic renal cell carcinoma presenting as a hemorrhoid.Metastatic, noncolorectal carcinoma involving the anal canal is exceptionally rare, with only 3 cases being described in the medical literature. We report the case of a 53-year-old man with an anal mass clinically presenting as a large, thrombosed, internal hemorrhoid. The patient had a history of nephrectomy for renal cell carcinoma 9 years previously. The resected anal lesion was histologically identical to the primary tumor in the kidney, showing features of renal cell carcinoma of the clear cell type. To the best of our knowledge, this is only the fourth reported case of metastatic, noncolorectal carcinoma involving the anal canal and is the first report of a renal cell carcinoma metastasis to this site.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
4/5. Double flap technique to reconstruct the anal canal after concurrent surgery for fistulae, abscesses and haemorrhoids.Benign anorectal conditions, such as abscess, fistulas and haemorrhoids may occur in the same patients, requiring wide excision of the diseased tissues. This may result in a large de-epithelized area of the anal canal, and removal of perianal skin, eventually leading to a stricture. A rectal mucosal advancement sutured to the apex of a skin rotation flap has been successfully used in four patients to partially reconstruct the anal canal and prevent the formation of an anal stenosis. Complex anal fistulas may be associated with haemorrhoids requiring a wide local excision. A large wound with loss of skin and epithelium may result, which is likely to heal causing an anal stricture. After simple open haemorrhoidectomy, three muco-cutaneous bridges are usually left by the surgeon at the end of the operation to prevent a stenosis, but this may be impossible to perform following haemorrhoidectomy and fistulectomy, procedures requiring wider tissue excision. A technique to create a muco-cutaneous bridge despite an extensive surgical wound had been successfully adopted in four patients with long standing multiple anal fistulas, pelvirectal abscess and haemorrhoids.- - - - - - - - - - ranking = 3keywords = canal (Clic here for more details about this article) |
5/5. Laser ablation of squamous cell carcinoma in situ of the anal canal. A case report.A case of squamous cell carcinoma in situ of the anal canal was discovered incidentally during a hemorrhoidectomy in a man. The anal canal was evaluated by colposcopy prior to ablation of the lesion with a CO2 laser. To our knowledge, this technique has not been reported previously.- - - - - - - - - - ranking = 3keywords = canal (Clic here for more details about this article) |