Operative considerations for rectovaginal fistulas

To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs pre...

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Published inWorld journal of gastrointestinal surgery Vol. 7; no. 8; pp. 133 - 137
Main Authors Kniery, Kevin R, Johnson, Eric K, Steele, Scott R
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 27.08.2015
Subjects
fistulas
fistulas;Anovaginal
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Rectovaginal
Anovaginal fistulas
Rectovaginal fistulas
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Summary:To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas.
Bibliography:Rectovaginal fistulas;Anovaginal fistulas
To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas.
Kevin R Kniery;Eric K Johnson;Scott R Steele;Department of Surgery,Division of Colorectal Surgery,Madigan Army Medical Center
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Telephone: +1-504-6554276
Author contributions: All authors contributed to this manuscript.
Correspondence to: Kevin R Kniery, MD, General Surgery Resident, Department of Surgery, Division of Colorectal Surgery, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, United States. krkniery@gmail.com
ISSN:1948-9366
1948-9366
DOI:10.4240/wjgs.v7.i8.133