PT  - JOURNAL ARTICLE
AU  - KOMORI, KOJI
AU  - KINOSHITA, TAKASHI
AU  - OSHIRO, TAIHEI
AU  - OUCHI, AKIRA
AU  - ITO, SEIJI
AU  - ABE, TETSUYA
AU  - SENDA, YOSHIKI
AU  - MISAWA, KAZUNARI
AU  - ITO, YUICHI
AU  - NATSUME, SEIJI
AU  - HIGAKI, EIJI
AU  - OKUNO, MASATAKA
AU  - HOSOI, TAKAHIRO
AU  - NAGAO, TAKUYA
AU  - KUNITOMO, AINA
AU  - OKI, SATOSHI
AU  - TAKANO, JIN
AU  - SUENAGA, YASUHITO
AU  - MAEDA, SHINGO
AU  - DEI, HIDEYUKI
AU  - NUMATA, YOSHIHISA
AU  - SHIMIZU, YASUHIRO
TI  - Surgical Strategy for Rectovaginal Fistula After Colorectal Anastomosis at a High-volume Cancer Center According to Image Type and Colonoscopy Findings
AID  - 10.21873/anticanres.13704
DP  - 2019 Sep 01
TA  - Anticancer Research
PG  - 5097--5103
VI  - 39
IP  - 9
4099  - http://ar.iiarjournals.org/content/39/9/5097.short
4100  - http://ar.iiarjournals.org/content/39/9/5097.full
SO  - Anticancer Res2019 Sep 01; 39
AB  - Background/Aim: The reported incidence of rectovaginal fistula is very low. Although some case reports have described surgical procedures, no systematic approach to the treatment of rectovaginal fistula according to diagnostic image and colonoscopy findings has been proposed. We present a comprehensive surgical strategy for rectovaginal fistula after colorectal anastomosis according to diagnostic image and colonoscopy findings. Patients and Methods: This retrospective study included 11 patients who developed rectovaginal fistula after colorectal anastomosis. Rectovaginal fistula was classified into 4 types according to contrast enema images and colonoscopy findings, i.e., “Alone type”, “Dead space type”, “Anastomotic stricture type”, and “Dead space and Anastomotic stricture type”. The surgical strategies were “Diversion (Stoma)”, “Percutaneous drainage”, “Anastomotic stricture type”, “Endoscopic balloon dilation”, “Curettage of foreign bodies”, “Simple full-thickness closure”, “Split-thickness closure”, “Pedicled flaps packing”, and “Reanastomosis”. The surgical strategy appropriate for each rectovaginal fistula type was investigated. Results: Among “Alone type” cases, 5 (71.4%) healed with “only Diversion (Stoma)”. “Alone type” cases (n=11) and all other cases (n=4) healed with “only Diversion (Stoma)” (n=5) or any other method (n=6) (p=0.022). Conclusion: For treatment of rectovaginal fistula after colorectal anastomosis, less invasive treatment approaches should be attempted first.