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Complications of Anorectal Surgery


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Table of Contents

Complication of Anorectal Surgery

Table of Content

1. Surgery for Anorectal Abscess - Adrian Ortega

a. Simple

b. Horseshoe

c. Fournier's Fistula Herand Abcarian

2. Anorectal fistula Surgery Marc Singer

a. Fistulotomy/Fistulectomy, Seton - Abcarian

b. Plugs

c. Glue

d. Flaps (ERFA, DIFA)


f. Fistuloscopy (VAAFT)

g. CA risk with no therapy?

h. What makes Crohn's fistulas tough?

i. Which is worse, incontinence due to fistula or from fistula surgery?

3. Hemorrhoids Jose Cintron(a-c)

a. Milligan-Morgan

b. Ferguson

c. Whitehead

d. Stapled Hemorrhoidopexy Herand Abcarian

e. Suture Hemorrhoidopexy Herand Abcarian

f. THD +/- mucopexy Marc Brand (g-o)

g. Excision of Thrombosed External Hemorrhoids

h. Injection Sclerotherapy

i. Ligasure

j. Laser

k. Infrared

l. Cryo

m. TCH

n. Do hemorrhoids cause cancer? o. HET

4. Anal Fissure Richard Nelson

a. Midline Sphincterotomy (Keyhole)

b. Lateral Internal Sphincterotomy (recurrence, non-healing, incontinence)

c. Anal Stretch

d. Recurrence of Anal Fissure

e. Botox

f. Incontinence after fissure surgery. Why is it never treated?

5. Pilonidal Cyst Johan Nordenstam

a. Left Open

b. Primary closed

c. Flaps

d. Bascom

e. Meningitis??

f. VAC complication


6. Hidradenitis Suppurativa Jacqueline Harrison

a. Delayed healing

b. STSG (slough/failure)

c. Missed Fistulas

d. Anal Stricture

e. Rampant recurrent hidradenitis

f. How much can hidradenitis recur locally? Why?

g. Funny bugs

h. CA?<

7. Perineal Repair of Rectal Prolapse Richard Nelson

a. Bleeding

b. Disruption

c. Rectal necrosis (prior LAR)

d. Evisceration

e. Anaesthetic

f. Airline Toilet

8. Rectocele Repair (ODS) Steven Brown

a. STARR-Transstar

b. Transvaginal

c. Transperineal +/- Mesh

d. Why fix it?

e. Complications Linda Farkas

9. RV Fistula Repair Slawomir Marecik

a. Bleeding

b. Sepsis

c. Recurrence

d. But why is it so tough?

e. Fistulotomy? With later gracilis?

10. Incontinence Anders Mellgren

a. Sphincter Repair

b. Graciloplasty

c. Gluteus Repair

d. SNS

e. What about the colon? MACE

f. PTNS?

11. Transanal Excision of Rectal Tumor ( TEM or TAMIS) Vivek Chaudhry

a. Bleeding

b. Infection

c. Fistula

e. Missed Cancer

12. Anal Stenosis Jennifer Blumetti

a. Dilation (perforation)

b. Flaps (U, House, S)

c. Level? Pouch/anal, LAR Anastomosis

13. Retrorectal Cyst Nell Maloney-Patel

a. Bleeding

b. Infection

c. Rectal perforation

d. Incomplete excision/recurrence

14. York Mason Procedure Herand Abcarian

a. Bleeding

b. Infection

c. Rectal Cutaneous Fistula, Why is this rare?

d. Incontinence

15. Pull Through Procedures Jennifer Blumetti


b. Bleeding

c. Disruption

d. Presacral Abscess

e. Non-healing Cavity

f. Stricture

g. Prolapse

h. Long-term results of pull through in infants/children related to emptying/continence

16. Perineal Wound Post APR Torbjoern Holm

a. Cancer

b. Crohn's disease

c. Infection

d. Disruption

e. Delayed healing

f. Complication of Flap Closure, VRAM, etc.

g. Dead space

About the Author

Herand Abcarian, MD, FACS
Professor of Surgery
Division of Colon and Rectal Surgery
John H. Stroger Hospital of Cook County
Chicago, IL 60612


"The purpose is to help guide colorectal surgeons and colorectal surgery trainees through complications of anorectal surgery and their management. ... It is written for junior colorectal surgery faculty, fellows, or general surgeons with a high volume of anorectal cases. ... In the end, this book is intended to provide advice to those who do a lot of anorectal surgery ... ." (Irena Gribovskaja-Rupp, Doody's Book Reviews, July, 2017)

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