RT Journal Article
SR Electronic
T1 Surgical Strategy for Rectovaginal Fistula After Colorectal Anastomosis at a High-volume Cancer Center According to Image Type and Colonoscopy Findings
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5097
OP 5103
DO 10.21873/anticanres.13704
VO 39
IS 9
A1 KOMORI, KOJI
A1 KINOSHITA, TAKASHI
A1 OSHIRO, TAIHEI
A1 OUCHI, AKIRA
A1 ITO, SEIJI
A1 ABE, TETSUYA
A1 SENDA, YOSHIKI
A1 MISAWA, KAZUNARI
A1 ITO, YUICHI
A1 NATSUME, SEIJI
A1 HIGAKI, EIJI
A1 OKUNO, MASATAKA
A1 HOSOI, TAKAHIRO
A1 NAGAO, TAKUYA
A1 KUNITOMO, AINA
A1 OKI, SATOSHI
A1 TAKANO, JIN
A1 SUENAGA, YASUHITO
A1 MAEDA, SHINGO
A1 DEI, HIDEYUKI
A1 NUMATA, YOSHIHISA
A1 SHIMIZU, YASUHIRO
YR 2019
UL http://ar.iiarjournals.org/content/39/9/5097.abstract
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.