Martius advancement flap for low rectovaginal fistula: short- and long-term results

Pitel, Sophie; Lefèvre, Jérémie H.; Parc, Yann; Chafaı̈, Najim; Shields, Conor; Tiret, Emmanuel

doi:10.1111/j.1463-1318.2011.02544.x

Cited by 80 publications

(46 citation statements)

References 21 publications

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“…Pitel et al . reported a success rate of 65% in 20 cases, with a median follow‐up of 29 months (range 2–210 months) using a diverting stoma in 70%. In their series, the overall morbidity rate was 15%.…”

Section: Discussionmentioning

confidence: 99%

Use of the Martius advancement flap for low rectovaginal fistulas

Trompetto¹,

Luc²,

Novelli

et al. 2019

Colorectal Disease

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Aim The percentage recurrence after any surgical treatment for low rectovaginal fistula (LRVF) is unacceptably high. The aim of this study was to evaluate the short‐ and long‐term results of the Martius procedure in a carefully selected series of patients with a LRVF of at least 1 cm diameter who had had at least two previous surgeries or in the presence of chronically inflamed local tissues. Method Between January 2009 and April 2017, 24 patients with the abovementioned features were prospectively included in this study. Success was defined both as the absence of any subjective symptoms and the fistula, as confirmed by evaluation under anaesthesia. Postoperative complications were assessed using the Clavien–Dindo classification. Quality of life (SF‐12 score), quality of sexual life [Female Sexual Function Index (FSFI) score] and continence [Cleveland Clinic Incontinence Score (CCIS)] were also determined pre‐ and postoperatively. Results The mean follow‐up was 42 ± 29 months (range 3–101 months). The overall success rate was 91.3% (22/24 patients). The median operation time was 50 min (range 45–70 min), and the median hospital stay was 3.5 days (range 3–5 days). No major complications occurred. Pre‐ and postoperative CCIS did not differ [1 (range 0–3.5)]. The postoperative SF‐12 score improved both in terms of the physical (33.6 ± 7.2 vs 50.8 ± 7.8; P < 0.001) and mental (32.6 ± 6.7 vs 56.3 ± 7.8; P < 0.001) components. FSFI improved from 19.5 ± 6.6 to 24.4 ± 6.3 (P < 0.001). Conclusion The Martius procedure should be considered as the first‐line method of treatment in carefully selected cases of LRVF.

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Section: Discussionmentioning

confidence: 99%

Use of the Martius advancement flap for low rectovaginal fistulas

Trompetto¹,

Luc²,

Novelli

et al. 2019

Colorectal Disease

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“…Minor transient morbidity has been reported, including postoperative pain [8], labial abscess [8], minor wound complications [9], labial numbness [10], and dyspareunia [11]. Longer-term complications include paraesthesia [11], discomfort [11], and cosmetic dissatisfaction [10].…”

Section: Discussionmentioning

confidence: 99%

Martius graft for TOT extrusion: a case series

2015

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“…Approach for local repair may be endorectal, trans vaginal or trans perineal. Various tissue options available for interposition include omental flap, gracilis flap, adipose tissue from labia majora [7], bulbocavernosus [8], pubococygeus [9] and gracilis muscle [10]. Direct local repair though attractive because of its minimally invasive nature is often unsuccessful since anovaginal septum is a thin, poorly vascularized structure with successful healing reported in 66.7 % cases [6].…”

Section: Discussionmentioning

confidence: 99%

Rectovaginal Fistula with Anastomotic Stricture Post Anterior Resection – Sphincter Preservation, a Viable Option

Pai

Desouza

Menezes

et al. 2015

Indian J Surg Oncol

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Rectovaginal fistula [RVF] is a devastating complication of anterior resection whose incidence worldwide is on a rise with widespread use of staplers for the rectal anastomosis. It is a special surgical challenge for the treating surgeon with limited suitable options available to treat this difficult situation. As there is no consensus on its management, most often patient ends up with permanent stoma and overall inferior quality of life. We are presenting a case of post anterior resection RVF which was treated with intersphincteric resection followed by hand sewn coloanal anastomosis. An intersphincteric resection avoids dissection in a previously violated rectovaginal plane and improves chances of sphincter preservation. A well vascularized colonic graft with hand sewn coloanal anastomoses well below the site of fistula and omental interposition further avoids the chances of recurrence of fistula.

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Martius advancement flap for low rectovaginal fistula: short- and long-term results

Abstract: The Martius flap procedure for LRVF, had a success rate of about 60% and a low morbidity.

Cited by 80 publications

References 21 publications

Use of the Martius advancement flap for low rectovaginal fistulas

Use of the Martius advancement flap for low rectovaginal fistulas

Martius graft for TOT extrusion: a case series

Rectovaginal Fistula with Anastomotic Stricture Post Anterior Resection – Sphincter Preservation, a Viable Option

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