Introduction
Abdominoperineal resection (APR) is one of several surgical procedures indicated for the treatment of colorectal carcinoma. The procedure involves the removal of the distal colon, rectum, and anal sphincters, resulting in a permanent colostomy. Permanent colostomies are associated with multiple complications, including a reduced quality of life. Anal reconstruction using the gracilis muscle for sphincter control is a viable alternative to permanent colostomy.

Case Details
This case concerns a 43-year-old woman who requested the reversal of a permanent colostomy. She had previously undergone a Hartmann’s colostomy following an abdominoperineal resection and total abdominal hysterectomy for a suspected colorectal carcinoma. On her request, colostomy reversal and gracilis muscle sphincteroplasty were performed.

Outcome
Eight months after the procedure, the patient achieved good continence, improved nutritional intake, and gained approximately 13 kilograms in weight.

Conclusion
The successful colostomy reversal and gracilis sphincteroplasty demonstrated the effectiveness of graciloplasty in restoring continence and improving the quality of life in selected patients with permanent colostomies.