Rectovaginal Fistula with Anastomotic Stricture Post Anterior Resection -Sphincter Preservation, a Viable Option

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• 作者：Vishwas Pai ; Ashwin Desouza ; Jean Louis De Menezes…
• 关键词：Recto vaginal fistula ; Intersphincteric resection ; Post anterior resection stricture
• 刊名：Indian Journal of Surgical Oncology
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：6
• 期：3
• 页码：256-258
• 全文大小：2,819 KB
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• 作者单位：Vishwas Pai (1)
  Ashwin Desouza (1)
  Jean Louis De Menezes (1)
  Avanish Saklani (1)
  
  1. Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
  
• 刊物主题：Surgical Oncology; Oncology; Surgery;
• 出版者：Springer India
• ISSN：0976-6952

文摘

Rectovaginal fistula [RVF] is a devastating complication of anterior resection whose incidence worldwide is on a rise with widespread use of staplers for the rectal anastomosis. It is a special surgical challenge for the treating surgeon with limited suitable options available to treat this difficult situation. As there is no consensus on its management, most often patient ends up with permanent stoma and overall inferior quality of life. We are presenting a case of post anterior resection RVF which was treated with intersphincteric resection followed by hand sewn coloanal anastomosis. An intersphincteric resection avoids dissection in a previously violated rectovaginal plane and improves chances of sphincter preservation. A well vascularized colonic graft with hand sewn coloanal anastomoses well below the site of fistula and omental interposition further avoids the chances of recurrence of fistula. Keywords Recto vaginal fistula Intersphincteric resection Post anterior resection stricture