Puborectal sling interposition combined with seton drainage for pouch-vaginal fistula after rectal cancer surgery with colonic J pouch-anal reconstruction: report of a case.

Abstract

The management of postoperative rectovaginal fistula (RVF) after rectal cancer surgery is difficult and requires reconstruction of the anastomotic site and fistula. Though various surgical procedures have been reported for the repair of RVFs, the results of surgical repair are often unsatisfactory, and failure of the initial repair leads to difficulty in the later operations. Furthermore, it has been reported that cases associated with local infection result in low success rates. We report a case of an 80-year-old woman with a recurrent colonic J pouch-vaginal fistula after anoabdominal rectal resection with partial internal sphincteric resection, who achieved a good outcome following a repair using a puborectal sling interposition combined with seton drainage. It may be a useful option for RVF management in repair of such pouch-vaginal fistula after coloanal anastomosis with intersphincteric resection.

• Authors: Aya Kawamoto, Yasuhiro Inoue, Masato Okigami, Yoshinaga Okugawa, Junichiro Hiro, Yuji Toiyama, Koji Tanaka, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
• Journal: International surgery (Int Surg) 2014 Nov-Dec Vol. 99 Issue 6 Pg. 710-3 ISSN: 2520-2456 [Electronic] Italy
• PMID: 25437575 (Publication Type: Case Reports, Journal Article)

Chemical References

• Contrast Media
• Barium Sulfate

Topics

• Aged, 80 and over
• Anal Canal (surgery)
• Anastomosis, Surgical
• Barium Sulfate
• Colonoscopy
• Contrast Media
• Drainage
• Enema
• Female
• Humans
• Ileostomy
• Neoplasm Staging
• Postoperative Complications (etiology, surgery)
• Proctocolectomy, Restorative
• Rectal Neoplasms (surgery)
• Rectovaginal Fistula (etiology, surgery)