Outcomes of Rectovaginal Fistula Repair

Byrnes, J.N.; Schmitt, Jennifer; Faustich, Benjamin M.; Mara, Kristin C.; Weaver, Amy L.; Chua, Heidi K; Occhino, John A.

doi:10.1097/spv.0000000000000373

Cited by 27 publications

(20 citation statements)

References 20 publications

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“…In Mayo Clinic series, it was reported that 54% of their patients' RVF were due to inflammatory bowel disease whereas 11% were secondary to other reasons (16). Similarly, in our series, 50% (n=3) of patients' RVF were secondary to CD.…”

Section: Discussionsupporting

confidence: 73%

Rektovajinal Fistül Onarımı İçin Martius Flebi: Operatif Teknik ve Postoperatif Sonuçlar

Aghayeva¹,

Atasoy²,

Aytaç³

et al. 2020

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Amaç: Rektovajinal fistülün (RVF) en sık nedeni obstetrik travmadır, diğer en sık görülen neden ise Crohn hastalığıdır (CH). Bu konuda sfinkteroplasti, gracilis flepleri, Martius flepleri, fekal diversiyon ve ilerletme flepleri gibi çeşitli cerrahi seçenekler tartışılmaktadır. Bu çalışmanın amacı, Martius flep teknikğini ve mevcut hastaların uzun dönem cerrahi sonuçlarının, yaşam kalitesinin ve cinsel aktivite sonuçlarının sunulmasıdır. Yöntemler: Martius flep prosedürü uygulanan RVF'li altı hasta bu çalışmaya dahil edildi. Hasta demografisi, perioperatif sonuçlar, yaşam kalitesi (QoL), cinsel fonksiyon ve komplikasyonları içeren kısa ve uzun dönem sonuçları değerlendirildi. Bulgular: Nisan 2014 ve Ağustos 2014 arasında RVF'li altı kadın hastaya Martius flep prosedürü uygulandı. Ortalama yaş ve vücut kitle indeksi sırasıyla 47 ± 14.17 (dağılım, 33-68) ve 25 (dağılım 20-36) idi. Operasyon endikasyonları Crohn hastalığı (n = 3), obstetrik travma (n = 1), stapler yalnış tetiklenmesi (n = 1) ve rektosel onarımı (n = 1) içeren cerrahi sonrası komplikasyon idi. Ortalama takip süresi 32 ± 1.47 (3-34 ay) idi. Kozmetik sonuçlar tüm hastalar için iyi idi. Kadın cinsel işlev indeksi (FSFI) sonucunda hastaların% 66'sı (n = 4) aktif cinsel yaşantıya sahipti. QoL tüm hastalar için iyi idi. CGoL skoru 0.8 idi. Beş hasta nüks olmadan takip edilirken, CH'li bir hastada 18 ay sonra nüks saptandı. Sonuç: Yukarıda belirtilen avantajlar göz önüne alındığında, Martius flebi deneyimli ellerde uygulandığında RVF onarımı için uygun bir teknik olarak görülmektedir.

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Section: Discussionsupporting

confidence: 73%

Rektovajinal Fistül Onarımı İçin Martius Flebi: Operatif Teknik ve Postoperatif Sonuçlar

Aghayeva¹,

Atasoy²,

Aytaç³

et al. 2020

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“…Gynecologic surgeons typically approach distal fistulae through a transvaginal approach, while colon and rectal surgeons may utilize a transperineal or endorectal approach. Definitive procedures, including pelvic exenteration and abdominoperineal resection, are more commonly utilized for RVF secondary to pelvic malignancy, when tissue compromise is likely …”

Section: Surgical Considerations and Treatmentmentioning

confidence: 99%

“…Definitive procedures, including pelvic exenteration and abdominoperineal resection, are more commonly utilized for RVF secondary to pelvic malignancy, when tissue compromise is likely. 40 An abdominal approach is most often required for the surgical treatment of colovaginal fistulae. Once the rectum and vagina are separated, the defects are debrided and closed in layers.…”

Section: Surgical Considerations and Treatmentmentioning

confidence: 99%

MRI review of female pelvic fistulizing disease

Hyde

Byrnes

Occhino

et al. 2018

Magnetic Resonance Imaging

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A wide variety of fistulae occur in the female pelvis, most of which cause significant morbidity. Diagnosis, characterization, and treatment planning may be difficult using traditional imaging modalities such as fluoroscopy and computed tomography. To date, there is no comprehensive literature review of the radiologic findings associated with various types of female pelvic fistulae, and furthermore, none dedicated to magnetic resonance imaging (MRI). In this article, we seek to provide a broad overview of the MRI characteristics of female pelvic fistulizing disease in combination with epidemiologic and clinical characteristics. MRI is often considered the imaging modality of choice for evaluation of fistulae owing to its superior soft‐tissue contrast and ability to provide surgeons with the highest quality information derived from just one study, including anatomic location of fistulae and associated pelvic pathology. In other instances, MRI can be complementary to the more traditional imaging techniques. This review will describe the etiology, anatomy, MRI findings, and treatment pearls for several of the more common pelvic fistulae found in female patients, including anovaginal, rectovaginal, colovaginal, vesicovaginal, colovesical, and other complex fistulae. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1172–1184

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“…Even though it is benign, the distressing and persistent symptoms interfere with daily activities and sexual life, and have a long-term potential detrimental impact on psychological health[ 2 , 3 ]. Obstetric trauma is the primary etiological factor for RVF, but it can also be acquired from local abscess, pelvic floor or rectal surgery, trauma, or radiotherapy[ 3 - 5 ]. Chronic inflammatory bowel disease (most commonly Crohn’s disease) is the second most common etiology with rates varying between 6% and 23%[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive endoscopic repair of rectovaginal fistula

Zeng¹,

He²,

Jiang³

et al. 2022

World J Gastrointest Surg

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BACKGROUND Surgical techniques for repair of rectovaginal fistula (RVF) have been continually developed, but the ideal procedure remains unclear. Endoscopic repair is a novel and minimally invasive technique for RVF repair with increasing reporting. AIM To review the current applications and preliminary outcomes of this technique for RVF repair, aiming to give surgeons an alternative in clinical practice. METHODS Available articles were searched according to the search strategy. And the sample size, fistula etiology, fistula type, endoscopic repair approaches, operative time and hospital stay, follow-up period, complication and life quality assessment were selected for recording and further analysis. RESULTS A total of 11 articles were eventually identified, involving 71 patients with RVFs who had undergone endoscopic repair. The principal causes of RVFs were surgery ( n = 51, 71.8%), followed by obstetrics ( n = 7, 9.8%), inflammatory bowel disease ( n = 5, 7.0%), congenital ( n = 3, 4.2%), trauma ( n = 2, 2.8%), radiation ( n = 1, 1.4%), and in two patients, the cause was unclear. Most fistulas were in a mid or low position. Several endoscopic repair methods were included, namely transanal endoscopic microsurgery, endoscopic clipping, and endoscopic stenting. Most patients underwent > 1-year follow-up, and the success rate was 40%-93%, and all cases reported successful closure. Few complications were mentioned, while postoperative quality of life assessment was only mentioned in one study. CONCLUSION In conclusion, endoscopic repair of RVF is novel, minimally invasive and promising with acceptable preliminary effectiveness. Given its unique advantages, endoscopic repair can be an alternative technique for surgeons.

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Outcomes of Rectovaginal Fistula Repair

Abstract: Recurrence rates after RVF repair are high and did not differ by fistula etiology. Abdominal repair of RVF had significantly fewer recurrences.

Cited by 27 publications

References 20 publications

Rektovajinal Fistül Onarımı İçin Martius Flebi: Operatif Teknik ve Postoperatif Sonuçlar

Rektovajinal Fistül Onarımı İçin Martius Flebi: Operatif Teknik ve Postoperatif Sonuçlar

MRI review of female pelvic fistulizing disease

Minimally invasive endoscopic repair of rectovaginal fistula

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