[Surgical treatment of rectovaginal fistula with vaginal rectangular flap].

Autor:	Mudrov AA; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia.; Russian Medical Academy of Postgraduate Education, Moscow, Russia., Omarova MM; Russian Medical Academy of Postgraduate Education, Moscow, Russia., Fomenko OY; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia., Blagodarnyi LA; Russian Medical Academy of Postgraduate Education, Moscow, Russia., Kostarev IV; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia.; Russian Medical Academy of Postgraduate Education, Moscow, Russia., Sokolova YA; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia., Serebriy AB; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia., Nagudov MA; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia., Titov AY; Ryzhikh National Medical Research Centre for Coloproctology, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2021 (7), pp. 5-11.
DOI:	10.17116/hirurgia20210715
Abstrakt:	Objective: To evaluate the early and long-term outcomes of rectovaginal fistula closure with vaginal rectangular flap. Material and Methods: There were 61 patients with rectovaginal fistula for the period 2012-2020. Median age of patients was 35 years [31; 48]. Postpartum fictula was observed in 27 (44.2%) cases, postoperative - 10 (16.4%) patients, inflammatory - 15 (24.6%) patients, other causes - 9 (14.8%) patients. Disease recurrence occurred in 29 (47.5%) patients. Results: Median follow-up period was 36.2 [6; 64] months. Postoperative recurrence of rectovaginal fistula occurred in 19 (31.1%) patients. Length of hospital-stay ranged from 3 to 36 days (median 14 [12; 16]). We analyzed the relationship between the risk of disease recurrence and various factors, including etiology of rectovaginal fistula, localization and diameter of the fistula, intraoperative cautery, previous surgeries and preventive colostomy. Conclusion: Vaginal rectangular flap is effective for rectovaginal fistula. Multivariate analysis confirmed two significant risk factors of postoperative recurrence: diameter of fistula over 5 mm and its localization in the rectum above the upper border of surgical anal canal (more than 7 mm from the dentate line).
Databáze:	MEDLINE
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