Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence.

Clinical and manometric results of Delorme's operation and sphincteroplasty were assessed retrospectively in patients undergoing this procedure for fecal incontinence and rectal prolapse. A series of 33 patients (11 males, 22 females; aged 18-83 years, mean 59) with external rectal prolapse were treated by Delorme's operation between 1989 and 1996. Mean follow-up was 39 months (range 7-84).

Clinical, manometric and sonographic assessment of the anal sphincters. A comparative prospective study.

One hundred patients with various anorectal disorders but intact anal sphincters were evaluated prospectively by three independent observers to determine the specificity, sensibility and accuracy of digital exploration and anal ultrasound compared to anal manometry, in assessing internal and sphincter hypertonicity (IH) and the relaxation of sphincters on straining (SR). Accuracy of the digital examination in evaluating IH was 80 vs 74%, while the SR was detected by the three observers in 82, 71 and 65% of cases. The thickness of internal sphincter increased with age (r = 0.

Management of perianal Crohn's disease. Results of a multicenter study in Italy.

Purpose: Management of perianal Crohn's disease is still controversial, and reports on large series are very few in the literature. The aim of this multicenter study was to investigate the outcome of both medical and surgical treatment in 225 patients.

Methods: Patients cared for at different institutions were followed up for a median of six years.

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.