Benign rectovaginal fistulas: management and results of a personal series

Abstract

Simple versus complex fistulas is the most determinant factor for healing. In IBD fistulas, ulcerative colitis shows better prognosis than Crohn's disease. For complex fistulas, a temporary diverting stoma seems necessary.

Innovative technique for the closure of rectovaginal fistula using Surgisis™ mesh

“…Particularly in complex rectovaginal fistula associated with Crohn's disease or after irradiation of the small pelvis, a variety of surgical options such as fistulotomy [4,5], long-term seton [6,7], transanal [8][9][10][11][12][13][14][15][16] or transvaginal [17] advancement flap, transperineal procedures, rectal sleeve advancement flap [18][19][20][21], bilateral gluteus muscle patching [22], bulbocavernous muscle flap [23] and, finally, proctectomy [24,25], have been applied to close the fistula. As primary healing rates after "traditional" surgery using flap techniques are somewhat disappointing [26,27], the aim of this study was to deter-137 Tech Coloproctol (2009) 13:135-140 mine short-term results on the feasibility and efficacy of an innovative management approach.…”

New Type of Seton with Irrigating Tube for the Treatment of High Complex Anal Fistula: A Simple and Effective Instrument

“…A variety of techniques have been used in an attempt to achieve a cure, including cutting and loose setons, staged fistulotomy and rectal or anocutaneous advancement flaps. 11, 21,22 The use of a new type of seton with an irrigating tube in the present study was associated with significant reductions in recurrence rate, length of stay and healing time compared with a conventional seton, but there were no significant differences in operation time or postoperative incontinence rates.…”

S3-Leitlinie: Rektovaginale Fisteln (ohne M. Crohn)

“…Vergleichende Studien mit anderen Verfahren, die diese sehr positiven Ergebnisse bestä-tigen, liegen nicht vor. [46,52,70,165,181,216,231], eine prospektive [18] und 9 retrospektive Studien [19,75,105,126,127,272,281,286,305]. Einen CrohnAnteil von mehr als 20% weisen 5 Studien auf [18,19,105,126,305].…”