Rectovaginal fistula after anterior resection of the rectum for cancer
Journal Title: Nowa Medycyna - Year 2015, Vol 22, Issue 1
Abstract
Authors present two patients who developed rectovaginal fistulas after anterior resection of the rectum for cancer. Although, the complication is uncommon it requires enough attention due to a dramatic decline in quality of life and high rate of recurrence after primary repair. Anterior resection of the rectum with a double stapling technique is a commonly used sphincter – preserving method of treatment for cancer. Most fistulas is a result of a damage to the vaginal wall which appears during resection of the rectum or colorectostomy. Interposition of the vaginal wall between the remnants of the colon and rectum during anastomosis was a presumed cause of a fistula in the first patient. A fistula in the second patient after previous hysterectomy, occurred due to a false anastomosis of the sigmoid colon with vagina. Proper qualification for an operation, competence in topographic anatomy of the pelvis, and appropriate surgical technique are essential methods of the severe complication avoidance. Treatment depends on localization, and diameter of a fistula, and the period of time from the primary operation to the diagnosis of a fistula. In general, low fistulas are repaired with transanal, transvaginal, or perineal approach. Whereas, high fistulas are operated with laparotomy.
Authors and Affiliations
Jacek Hermann, Tomasz Kościński, Urszula Piekarska-Skowrońska, Michał Dopierała
Keywords
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