title: New application of the gluteal-fold flap for the treatment of anorectal stricture.
abstract: OBJECTIVE
  Total intersphincteric resection (total ISR) is a surgical option for patients with advanced cancer of the lower rectum. However, anorectal stricture can develop after total ISR, which stretches from the anus to the lower rectum. Conventional anoplasty for anal stricture is often ineffective for them because the areas of stricture are long and the most proximal points of the strictures are too far for advancement flaps or rotation flaps to reach. We have developed a new surgical treatment method using a gluteal-fold flap (GFF) for anal stricture after total ISR.
  
  
  METHODS
  From April 2004 through June 2007, hemilateral GFFs were transferred to treat anorectal strictures after total ISR in three patients at the National Cancer Center Hospital East, Chiba, Japan. Postoperative results and anal function were evaluated.
  
  
  RESULTS
  In all three patients, GFFs were successfully transferred, and good dilation of the anorectal stenosis was achieved. Postoperative anal function was satisfactory.
  
  
  CONCLUSIONS
  The GFF has a rich vascular supply and can be simply and reliably transferred. We believe that GFF transfer is an excellent option for treating anorectal strictures after total ISR.
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. sunaot@saitama-med.ac.jp
authors.forename: Sunao
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asano
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
mesh_terms: D001003:Anal Canal / Q000473:pathology* / Q000601:surgery*; D002081:Buttocks / Q000601:surgery*; D003251:Constriction, Pathologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012007:Rectum / Q000473:pathology* / Q000601:surgery*; D013524:Surgical Flaps