Abdominoperineal resection (APR) is one of several surgical procedures indicated for treating colorectal carcinoma. APR involves the removal of the distal colon, the rectum, and the anal sphincters, resulting in a permanent colostomy. Permanent
colostomies are associated with multiple complications including a low quality of life. Anal reconstruction, using the gracilis muscle for sphincter control is a viable  alternative to a permanent colostomy.
This is the case of a 43-year-old woman who requested the reversal of a permanent colostomy. She had a Hartman’s colostomy fashioned after undergoing an abdominoperineal resection and total abdominal hysterectomy for a suspected colorectal carcinoma. On her request, colostomy reversal and gracilis muscle sphincteroplasty were performed. Eight months after the procedure, she achieved good continence, improved feeding, and gained about 13 kilograms in weight. The successful colostomy reversal and gracilis sphincteroplasty demonstrated the effectiveness of graciloplasty in restoring patients’ continence.