Premium
The long‐term outcome of transvaginal anterior levatorplasty for intractable rectovaginal fistula
Author(s) -
Maeda K.,
Koide Y.,
Hanai T.,
Sato H.,
Masumori K.,
Matsuoka H.,
Katsuno H.
Publication year - 2015
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12977
Subject(s) - medicine , rectovaginal fistula , surgery , fistula , stoma (medicine) , rectum , vagina , fistulectomy , pouch
Aim 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.