Minimally invasive endoscopic repair of rectovaginal fistula

Zeng, Yi-Xian; He, Yinghua; Jiang, Yun; Jia, Fu; Zhao, Zi-Ting

doi:10.4240/wjgs.v14.i9.1049

Cited by 3 publications

(1 citation statement)

References 57 publications

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“…Two of five (40%) RVFs were successfully treated with transanal endoscopic surgery [57]. Recent review of endoscopic repairs of RVF by Zeng et al [58] includes 71 patients in 11 articles. The causes of RVFs were post-surgery in 51 patients (71.8%), obstetrics in 7 patients (9.8%), and inflammatory bowel disease in 5 patients (7%).…”

Section: Endoluminal Procedures Fibrin Glue Plug Andmentioning

confidence: 99%

Treatment of Rectovaginal Fistula

Maeda

Wada

Shida

2023

J Anus Rectum Colon

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Rectovaginal fistula (RVF) is a challenging complication with unsatisfactory success and a significant burden for the patients. With insufficient clinical data due to the rare entity, the present state of treatments for RVFs was reviewed especially form the point of factors to determine management, classifications, principle of treatment, conservative and surgical treatments with outcomes. Size, fistula localization and etiology, type of fistula; “simple” or “complex,” status of anal sphincter complex and surrounding tissue, presence or absence of inflammation, presence of diverting stoma, previous attempted repair and radiation therapy, patient's condition with co-morbidities, and surgeon's experience are important factors to determine the management of RVF. The inflammation should initially subside in cases with infection. Starting with conservative surgical options and interposing healthy tissue for complex or recurrent fistulas, invasive procedures will be performed if conservative treatment failed. Conservative treatment may be effective in RVFs with minimal symptoms and should be done for small RVFs for a 36 months usual period. Anal sphincter damage might need a repair of sphincter muscles along with RVF repair. Diverting stoma can initially be constructed in patients with severe symptoms and larger RVFs to relief the patient's pain. Simple fistula is usually indicated for local repair. Local repairs to transperineal and transabdominal approaches can be used for complex RVFs. Interposition of healthy, well-vascularized tissue can be required for more complex fistulas and abdominal procedures for high RVFs.

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Section: Endoluminal Procedures Fibrin Glue Plug Andmentioning

confidence: 99%

Treatment of Rectovaginal Fistula

Maeda

Wada

Shida

2023

J Anus Rectum Colon

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Postoperative rectovaginal fistula: stoma may not be necessary—a French retrospective cohort

Poitevin,

Hamel,

Ngoma

et al. 2024

Tech Coloproctol

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Background Postoperative rectovaginal fistula leads to a loss of patients’ quality of life and presents significant challenges to the surgeon. The literature focusing specifically on postoperative rectovaginal fistulas is limited. The objective of the present study is to identify factors that can enhance the success of the management of this postoperative rectovaginal fistula. Methods This retrospective multicentric study included all patients undergoing surgery for rectovaginal fistulas, excluding those for whom the etiology of rectovaginal fistula was not postoperative. The major outcome measure was the success of the procedure. Results A total of 82 patients with postsurgical fistulas were identified, of whom 70 were successfully treated, giving a success rate of 85.4%. On average, these patients required 3.04 ± 2.72 interventions. The creation of a diversion stoma did not increase the success rate of management [odds ratio (OR) = 0.488; 95% confidence interval (CI) 0.107–2.220]. Among the 217 procedures performed, 69 were successful, accounting for a 31.8% success rate. The number of interventions and the creation of a diversion stoma did not correlate with the success of management. However, direct coloanal anastomosis was significantly associated with success (OR = 35.06; 95% CI 1.271–997.603; p = 0.036) as compared with endorectal advancement flap (ERAF). Other procedures such as Martius flap did not show a significantly higher success rate. Conclusion The creation of a diversion stoma is not necessary in closing a fistula. ERAF should be considered as a first-line treatment prior to proposing more invasive approach such as direct coloanal anastomosis.

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A Gender Perspective on Coloproctological Diseases: A Narrative Review on Female Disorders

De Nardi,

Giacomel,

Orlandi

et al. 2024

JCM

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Coloproctological diseases, including both benign and malignant conditions, are among the most common diagnoses in clinical practice. Several disorders affect both men and women, while others are unique to women, or women are at a greater risk of developing them. This is due to anatomical, biological, and social conditions and also due to females’ exclusive capabilities of reproduction and pregnancy. In this context, the same proctological disease could differ between men and women, who can experience different perceptions of health and sickness. There is a raised awareness about the impact of different diseases in women and a growing need for a personalized approach to women’s health. In this review, we aim to summarize the specific features of the main coloproctological diseases, specifically in the female population. This includes common complaints during pregnancy, conditions linked to vaginal delivery, functional consequences after colorectal resections, and conditions presenting a gender disposition.

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Minimally invasive endoscopic repair of rectovaginal fistula

Cited by 3 publications

References 57 publications

Treatment of Rectovaginal Fistula

Treatment of Rectovaginal Fistula

Postoperative rectovaginal fistula: stoma may not be necessary—a French retrospective cohort

A Gender Perspective on Coloproctological Diseases: A Narrative Review on Female Disorders

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