Objective. Searching for optimal highly effective surgical approach for anal sphincter insufficiency via anal ring autoplasty.

Material and methods. The study enrolled 62 patients with anal sphincter insufficiency between 2004 and 2020 at the Russian Railways Hospital (Makhachkala). Inclusion criteria: complaints of intestinal incontinence and objective indicators of reduced pressure in anal canal Patients meeting selection criteria were divided into four groups: group 1 — patients with anal sphincter incontinence after correction of anorectal defects; group 2 — patients with anal sphincter incontinence after proctological surgery; group 3 — anal sphincter incontinence after childbirth; group 4 — patients with idiopathic anal sphincter incontinence. Correction of anal incontinence was performed original technique of displaced perianal dermal fat flaps.

Results. Immediate results were evaluated after 3 weeks, long-term results — after 6 months and 1 year. We assessed the following criteria: patient satisfaction with treatment outcomes, overall improvement in the quality of life, postoperative complications, WIS score (0-20) and degree of anus gaping (complete absence of gaping).

Conclusion. Good immediate and long-term treatment outcomes were observed in 87.6% and 46.8% of cases, respectively. Important prognostic criteria are damage to anal sphincter and basal pressure in anal canal. Original correction of anal sphincter incontinence has a long-term effect and requires widespread implementation in clinical practice.

Keywords. anal sphincter incontinence, autoplasty, dermal fat flaps