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The long-term outcome of transvaginal anterior levatorplasty for intractable rectovaginal fistula.

AbstractAIM:
Several procedures have been described for rectovaginal fistula with a wide range of success, but there is little information on the long-term outcome. The aim of the present study was to investigate the long-term outcome after transvaginal anterior levatorplasty (ALP) for intractable rectovaginal fistula.
METHOD:
Data of 16 consecutive patients undergoing transvaginal ALP with fistulectomy and closure of the rectum and vagina between 1998 and 2011 were prospectively recorded and retrospectively investigated to study the long-term outcome.
RESULTS:
Birth injury (n = 7), low anterior resection for rectal cancer (n = 3), pouch surgery for ulcerative colitis (n = 2) and a procedure for prolapse and haemorrhoids (n = 2) were the main causes of the fistula. Nine patients had a covering stoma before surgery. All patients underwent ALP, with a covering stoma in two patients. Infection occurred in one patient and wound rupture after surgery in another patient. These patients underwent reoperation by ALP. All fistulae had healed at a median follow-up of 84 (8-193) months after initial surgery or stoma closure.
CONCLUSION:
Transvaginal ALP is effective for the treatment of mid or low rectovaginal fistula. The results show that a graft is not necessary regardless of whether or not previous surgery has been performed.
AuthorsK Maeda, Y Koide, T Hanai, H Sato, K Masumori, H Matsuoka, H Katsuno
JournalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (Colorectal Dis) Vol. 17 Issue 11 Pg. 1002-6 (Nov 2015) ISSN: 1463-1318 [Electronic] England
PMID25891199 (Publication Type: Journal Article)
CopyrightColorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.
Topics
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Natural Orifice Endoscopic Surgery (methods)
  • Plastic Surgery Procedures (methods)
  • Rectovaginal Fistula (surgery)
  • Rectum (surgery)
  • Retrospective Studies
  • Surgical Flaps
  • Time Factors
  • Treatment Outcome
  • Vagina

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