Rectovaginal fistula: a new technique and preliminary results using collagen matrix biomesh

Göttgens, K. W. A.; Heemskerk, Jeroen; Gemert, Wim van; Smeets, R.; Stassen, Laurents P. S.; Beets, Geerard L.; Baeten, C. G. M. I.; Breukink, Stéphanie O.

doi:10.1007/s10151-014-1145-9

Cited by 11 publications

(15 citation statements)

References 22 publications

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“…79,80 However, inferior results are seen in irradiated patients. 81,82 Due to good results and low morbidity, proponents of mesh suggest that this technique should be the first step in the treatment of RVF, prior to GMFI. Larger randomized trials are needed to better evaluate the role and cost-effectiveness of bioabsorbable mesh in the management of complex RVF.…”

Section: Bioabsorbable Mesh Interpositionmentioning

confidence: 99%

Management of Complex Perineal Fistula Disease

Akiba

Rodrigues

Silva

2016

Clinics in Colon and Rectal Surgery

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Management of complex perineal fistulas such as high perianal, rectovaginal, pouch-vaginal, rectourethral, or pouch-urethral fistulas requires a systematic approach. The first step is to control any sepsis with drainage of abscess and/or seton placement. Patients with large, recurrent, irradiated fistulas benefit from stoma diversion. In patients with Crohn's disease, it is essential to induce remission prior to any repair. There are different approaches to repair complex fistulas, from local repairs to transperineal and transabdominal approaches. Simpler fistulas are amenable to local repair. More complex fistulas, such as those secondary to irradiation, require interposition of healthy, well-vascularized tissue. The most common flap used for this treatment is the gracilis muscle with good outcomes reported. Once healing is confirmed by imaging and endoscopy, the stoma is reversed.

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Section: Bioabsorbable Mesh Interpositionmentioning

confidence: 99%

Management of Complex Perineal Fistula Disease

Akiba

Rodrigues

Silva

2016

Clinics in Colon and Rectal Surgery

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“…In an attempt to simplify the closure still further some surgeons have described the interposition of biological mesh, such as acellular cadaveric dermal graft , crosslinked collagen matrix , porcine dermal graft or porcine small intestine mucosa . The biological nature of these different prostheses allows recellularization and revascularization to occur with an ability to reintegrate into the surrounding tissues.…”

Section: Discussionmentioning

confidence: 99%

“…The biological nature of these different prostheses allows recellularization and revascularization to occur with an ability to reintegrate into the surrounding tissues. Only few case reports and two case series reporting biological mesh interposition are available, each with encouraging results . Schwander et al .…”

Section: Discussionmentioning

confidence: 99%

“…In another series of 12 cases with various forms of recurrent RVF, Göttgens et al . reported success in seven after Permacol® mesh interposition. These healing rates are much higher than the 20% primary healing rate reported in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, biological mesh interposition using acellular cadaveric dermis (Alloderm®) or crosslinked (Permacol®) or non‐crosslinked porcine acellular dermal matrices (Strattice®, Surgisis®) has been proposed as an alternative to gracilis or Martius flaps. Encouraging results have been reported so far in case reports with such mesh interposition , but only two multicentric studies with 21 and 12 cases have been reported so far with 64% and 71% success rates .…”

Section: Introductionmentioning

confidence: 99%

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Is biological mesh interposition a valid option for complex or recurrent rectovaginal fistula?

2016

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Surgical treatment of deep-lying ano-/rectovaginal fistulas using a de-epithelialized “Singapore flap” (pudendal thigh flap)

et al. 2022

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Summary Background Rectovaginal fistulas represent 5% of all anorectal fistulas. For affected women, this pathology is associated with a reduction in quality of life (QoL) and self-esteem. Most commonly used methods of surgical closure have high recurrence rates or permanent perineal complaints, which in turn lead to negative effects on QoL and self-esteem. A fistula closure, using the “de-epithelialized Singapore flap” (SF), can be a good alternative therapy strategy. Method Our retrospective case series processes the long-term results of seven patients who were operated on for ano-/rectovaginal fistula using the SF. All patients underwent surgery at the University Hospital Graz, between May 2012 and July 2015. The data of the surgical follow-up examinations were collected and an additional telephone survey was carried out. The procedure is presented based on a structured description. All procedures were performed jointly by the Department of General Surgery and the Department of Plastic Surgery. Results The average age of the seven patients was 46.14 years (23–72 a). Five patients had a total of 12 previous operations with frustrating results. Of the seven patients treated, six had a permanent fistula closure (85.7%). The results of the telephone survey (n = 6) showed a high level of patient satisfaction (100%), and an improvement in QoL (83.3%), through our surgical method. In our cohort, neither urinary nor fecal incontinence occurred. Conclusion The treatment of an ano-/rectovaginal fistula using the “de-epithelialized pudendal thigh flap” (Singapore flap) is a promising treatment alternative. In particular, patients who have had previous proctological interventions show a benefit from this procedure.

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Rectovaginal fistula: a new technique and preliminary results using collagen matrix biomesh

Abstract: Our technique shows promising results. A local and simple technique with acceptable closure and morbidity rates, like our local repair with biomesh, would be ideal as a first step in treating RVFs. Long-term results are needed.

Cited by 11 publications

References 22 publications

Management of Complex Perineal Fistula Disease

Management of Complex Perineal Fistula Disease

Is biological mesh interposition a valid option for complex or recurrent rectovaginal fistula?

Surgical treatment of deep-lying ano-/rectovaginal fistulas using a de-epithelialized “Singapore flap” (pudendal thigh flap)

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