An Alternative in Surgical Treatment of Post-Irradiation Vesicovaginal and Rectovaginal Fistulas: THE Seromuscular Intestinal Graft (Patch)

MRáZ, J. P.; Sutorý, M

doi:10.1016/s0022-5347(17)34948-0

Cited by 29 publications

(11 citation statements)

References 13 publications

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“…The capacity of the bladder 6 months after surgery ranged between 220 and 280 ml, and it increased by 20 % in the following 2 years. There was no leakage over the next 3.5-5 postoperative years [5].…”

Section: Discussionmentioning

confidence: 78%

“…It was Mráz et al [5] that treated between 1977 and 1988 four patients with radiogenic fistulas (1.5-3 cm diameter) with the use of a seromuscular intestine interposition graft. As with our patient, the patients in that study were suffering from cervical carcinoma, and were primarily treated with radiotherapy and secondarily with radical hysterectomies.…”

Section: Discussionmentioning

confidence: 99%

“…This procedure has been performed by Mraz more than 20 years ago. We aim to give a detailed description of this surgical technique, that up to now is not available in an electronic or open-access journal [5].…”

Section: Introductionmentioning

confidence: 99%

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Surgical technique of a recurrent post-radiation vesicovaginal fistula with a small intestine graft

Vaso

Betschart

Egger³

et al. 2015

Arch Gynecol Obstet

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Vesicovaginal fistulas are devastating conditions for the affected women. The combination of a hysterectomy and radiation increases the fistula risk 5-10 times. Radiation-induced recurrent vesicovaginal fistulas have the lowest success rate and require the most demanding treatment. We present the case of a recurrent post-radiation vesicovaginal fistula treated with a small intestine graft after unsuccessful conservative and failed previous operative treatments. The surgical management with a small intestine graft led to a permanently closed fistula. We describe the surgical abdominal procedure step-wise and review the rather scarce, post-radiation fistula literature. The closure of a vesicovaginal fistula with a small intestine graft is a complex surgical treatment with a long-term, successful result. posterior exenteration was performed in 85%, 5% and 10% of patients, respectively. 12In 31 cases, exenteration was performed with a curative aim, and in 9 cases, exenteration was 13 performed with a palliative aim. The overall survival rates were 61.4% at five years and 14 51.1% at 10 years. For the 31 patients who underwent pelvic exenteration with a curative aim, 15 the overall survival rates were higher than those for the entire study population and were 72.6 16 % at five years and 59.4 % at 10 years. For the nine patients that underwent a palliative 17 exenteration, the overall survival rates were 19.1 % at five years and 0 % at 10 years. This is 18 to the best of our knowledge the biggest study of pelvic exenteration in patients with

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Surgical technique of a recurrent post-radiation vesicovaginal fistula with a small intestine graft

Vaso

Betschart

Egger³

et al. 2015

Arch Gynecol Obstet

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“…Surgical correction usually requires a pedicle flap or a tissue graft to enhance healing in a poorly vascularized area. The use of a Martius graft [1,2] rectus abdominis myocutaneous flap [3], seromuscular intestinal graft [4] and combined gastric and omental segments [5] have all been described as possible procedures to treat VVF. These procedures are technically demanding but the reported success rates are high.…”

Section: Discussionmentioning

confidence: 99%

Postirradiation Vesicovaginal Fistula Completely Resolved with Conservative Treatment

Madjar

Gousse

2001

Int Urogynecol J

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Postirradiation vesicovaginal fistulae (VVF) pose a great challenge for the urologist. The poorly vascularized radiated tissue surrounding the fistula impairs healing and makes operative repair technically demanding. Conservative treatment for postirradiation VVF is considered inappropriate, and to our knowledge has never previously been described. We present a case of a woman with postirradiation VVF that was resolved after transurethral coagulation and 3 weeks of catheterization.

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“…Insbesonders die ron Parks empfohlene tiefe Kolonkontinenzresektion mit transanater Sleeve-Anastomose zeigt nach der Literatur gute Ergebnisse [4,6,[8][9][10]. Es werden aber anch nichtresezierende Verfahren empfohlen, bei denen gesunde Darmwandanteile [7] oder Kolonanteile [3,11] ventral des Rektums interponiert werden. Es werden aber anch nichtresezierende Verfahren empfohlen, bei denen gesunde Darmwandanteile [7] oder Kolonanteile [3,11] ventral des Rektums interponiert werden.…”

Section: Diskussionunclassified

Die radiogene enterovaginale Fistel — Möglichkeiten der chirurgischen Versorgung

Denkers

Broß

1998

Coloproctol

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Between 1 Jan 1985 and 31 Dec 1996 more than 300 patients with rectovaginal fistula were operated in our clinic. Nineteen of these patients suffered from fistulas induced by irradiation because of gynecological carcinomas. In 18 cases we saw rectovaginal fistulas, in 1 case terminal ileum was involved in ad-diti¦ Low-anterior resection with colo-anal sleeve-anastomosis and -mostly -additional diverting colostomy could be performed in 10 cases. In 8 patients only a colostomy could be performed becaª of poor general condition, progressive recurŸ pelvic tumor or severe irradiation induced pelvic lesions. In 1 case local transperineal operation of the fistula was performed, followed by early postoperative dehiscence of the suture. Two patients died early postoperatively because of progressive tumor disease. In the patients with coto-anal steeve-anastomosis procedures we saw pardal dehiscences of the suture in 3 cases, but no further severe complications. At 28 Feb 1998 6 of the t0 patients with continence resections could be controlled. None of them suffered from incontinence of a reeurrent fŸ We therefore believe that low-anterior resection with colo-anal sleeve-anastomosis -as recommended by Parks -should be the method of choice in surgical therapy of radiation induced rectovaginal fistula, good general condition of the patient and exclusion of recurrent tumor disease provided. A synchronous temporary colostomy seems to/ead to a better healing of the anastomosis and therefore is recommendable.

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An Alternative in Surgical Treatment of Post-Irradiation Vesicovaginal and Rectovaginal Fistulas: THE Seromuscular Intestinal Graft (Patch)

Cited by 29 publications

References 13 publications

Surgical technique of a recurrent post-radiation vesicovaginal fistula with a small intestine graft

Surgical technique of a recurrent post-radiation vesicovaginal fistula with a small intestine graft

Postirradiation Vesicovaginal Fistula Completely Resolved with Conservative Treatment

Die radiogene enterovaginale Fistel — Möglichkeiten der chirurgischen Versorgung

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