Innovative technique for the closure of rectovaginal fistula using Surgisis™ mesh

Schwandner, O.; Fuerst, Alois; Kunstreich, K.; Scherer, Roland

doi:10.1007/s10151-009-0470-x

Cited by 61 publications

(32 citation statements)

References 29 publications

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“…The shortest mean or median follow-up in the 20 studies was 3 months, and the longest follow-up was 24.5 months ( [60][61][62] Unable to separate rectovaginal, anovaginal or pouch-vaginal fistulas = 3 [63][64][65][66][67][68][69][70][71] Inadequate f/up = 1 59 Patients included in later publication = 19 [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] Review articles, comments, conference proceedings = 12 1 Eight of the 20 included articles reported continence levels pre-and postinsertion of the AFP. 25,79,80,84,85,89,92,94 There were no reported cases of any significant change in continence after insertion of the AFP in any of the patients in these studies (n ϭ 196 patients).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of the Anal Fistula Plug for Patients With Crohn's and Non-Crohn's Related Fistula-in-Ano

O’Riordan

Datta

Johnston

et al. 2012

Diseases of the Colon &Amp; Rectum

146

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of the Anal Fistula Plug for Patients With Crohn's and Non-Crohn's Related Fistula-in-Ano

O’Riordan

Datta

Johnston

et al. 2012

Diseases of the Colon &Amp; Rectum

146

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“…Schwandner et al [41] reported using Surgisis™ mesh in 21 patients with RVF, 9 with Crohn's RVF. After a mean follow up of 12 mo, they achieved a 78% closure rate in the Crohn's group and an 83% closure rate in the non-Crohn's RVF.…”

Section: Miscellaneous Repairsmentioning

confidence: 99%

“…After a mean follow up of 12 mo, they achieved a 78% closure rate in the Crohn's group and an 83% closure rate in the non-Crohn's RVF. The authors concluded that the mesh plug could be used as an adjunct to traditional advancement flap repair or muscle interposition, or possibly it could be used as an initial operation [41] . In a study by O'Connor et al [42] , the use of the fistula plug was studied in patients with Crohn's fistulae (2 with RVF) with an 80% success rate.…”

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confidence: 99%

Contemporary surgical management of rectovaginal fistula in Crohn's disease

Valente

Hull

2014

WJGP

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Rectovaginal fistula is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a women's quality of life. Successful management is possible only after accurate and complete assessment of the entire gastrointestinal tract has been performed. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics. Before treatment is undertaken, establishing reasonable goals and expectations of therapy is essential for both the patient and surgeon. This article aims to highlight the various surgical techniques and their outcomes for repair of CD associated rectovaginal fistula.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Rectovaginal fistula; Crohn's disease; Fistula; Advancement flap; Sleeve advancement; Episioproctotomy Core tip: Rectovaginal fistula secondary to Crohn's disease is a devastating and disabling condition with a significant negative impact on quality of life. Furthermore, these fistulae pose an extremely challenging dilemma for the clinician with unique and often frustrating management challenges. Medical management is often futile and surgery may offer the only chance for cure. In this article, we aim to review the various treatment options to close these difficult to treat fistulae, with an emphasis on surgical technique and complex decision making. INTRODUCTIONFistula-in-ano is the most common perianal manifestation of Crohn's disease (CD) and was first reported by Gabriel [1] in 1921, nine years before Crohn et al [2] identified regional enteritis as a clinical entity. These fistulae are classified by their relationship to the sphincter complex as either high (supra-or extra-sphincteric vs low (inter-or trans-sphincteric). Low fistulae that transverse the anal sphincter are more appropriately named anovaginal fistulae, but by convention, all such fistulae are termed rectovaginal fistula (RVF). After obstetrical trauma, CD is the most common etiological factor for RVF, and will occur in up to 10% of women with CD [3,4] . Rectovaginal fistulae secondary to CD are associated with significant morbidity and carry an increased risk for proctectomy [5,6] . It is a devastating and disabling condition and is a source of considerable social embarrassment Contemporary surgical management of rectovaginal fistula in Crohn's diseaseMichael A Valente, Tracy L Hull and has a significant negative impact on quality of life. Furthermore, CD associated RVF are an extremely challenging dilemma for the clinician and present unique and often frustrating management challenges. In this article, we aim to review the various treatment options to close these difficult to treat fistulae, with an emphasis on surgical technique and decision making. PRESENTATION AND DIAGNOSISThe presence of a fis...

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“…Several authors reported that a successful outcome can be achieved without the use of a stoma [7,13,21]. However, it is often stated that in difficult cases faecal diversion should be considered.…”

Section: Discussionmentioning

confidence: 97%

Rectal sleeve advancement for the treatment of persistent rectovaginal fistulas

Schouten¹,

Oom²

2009

Tech Coloproctol

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Innovative technique for the closure of rectovaginal fistula using Surgisis™ mesh

Abstract: The preliminary success rate for this innovative technique using Surgisis mesh for the closure of rectovaginal fistulas is promising. Further studies are needed to assess the definite role of this novel technique in comparison to traditional surgical procedures.

Cited by 61 publications

References 29 publications

A Systematic Review of the Anal Fistula Plug for Patients With Crohn's and Non-Crohn's Related Fistula-in-Ano

A Systematic Review of the Anal Fistula Plug for Patients With Crohn's and Non-Crohn's Related Fistula-in-Ano

Contemporary surgical management of rectovaginal fistula in Crohn's disease

Rectal sleeve advancement for the treatment of persistent rectovaginal fistulas

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