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Surgical repair of rectovaginal fistulas in patients with Crohn's disease.

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Citation: European Journal of Obstetrics, Gynecology, & Reproductive Biology. 171(1):166-70, 2013 Nov.PMID: 24011379Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery | Surgery/Colorectal SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Crohn Disease/co [Complications] | *Crohn Disease/su [Surgery] | *Digestive System Surgical Procedures/mt [Methods] | *Rectovaginal Fistula/su [Surgery] | Adult | Female | Humans | Middle Aged | Rectovaginal Fistula/et [Etiology] | Rectum/su [Surgery] | Retrospective Studies | Surgical Flaps | Treatment Outcome | Vagina/su [Surgery]ISSN:

0301-2115

Name of journal: European journal of obstetrics, gynecology, and reproductive biologyAbstract: CONCLUSIONS: This case series illustrates several techniques utilized for the repair of RVF in patients with Crohn's disease. The use of a bulbocavernosus flap during the primary repair of RVF in this patient population may be considered to bolster the rectovaginal septum. Copyright 2013 Elsevier Ireland Ltd. All rights reserved.OBJECTIVES: To report surgical outcomes of patients who underwent rectovaginal fistula (RVF) repair with a history of Crohn's disease utilizing several reconstructive techniques.RESULTS: During the study period, six women with the diagnosis of Crohn's disease and RVF underwent surgical management. Five patients had a vaginal advancement flap (VAF) by Female Pelvic Medicine and Reconstructive Surgery and one patient was treated by the rectal advancement flap by Colorectal Surgery. The failure rate in our study population was 33% (2/6). Of note, two of the patients who had a successful VAF had a previous failure after RAF. In addition, four patients who had a repair via the transvaginal approach had a concomitant pedicled flap procedure (i.e. Martius or gracilis flap). The average follow-up for all our patients was 5 months (+/- 6.5 months). No patients failed if they received a VAF with a concomitant flap procedure.STUDY DESIGN: Retrospective case series of women (n=6) with Crohn's disease surgically treated with either vaginal or rectal advancement flaps. Demographic information and data specific to Crohn's disease at the time of surgery were collected. In addition, operative reports and postoperative follow-up visits were reviewed.All authors: Nosti PA, Sokol AI, Stahl TJDigital Object Identifier:

http://dx.doi.org/10.1016/j.ejogrb.2013.08.011

Date added to catalog: 2014-08-21

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available		24011379

CONCLUSIONS: This case series illustrates several techniques utilized for the repair of RVF in patients with Crohn's disease. The use of a bulbocavernosus flap during the primary repair of RVF in this patient population may be considered to bolster the rectovaginal septum. Copyright 2013 Elsevier Ireland Ltd. All rights reserved.

OBJECTIVES: To report surgical outcomes of patients who underwent rectovaginal fistula (RVF) repair with a history of Crohn's disease utilizing several reconstructive techniques.

RESULTS: During the study period, six women with the diagnosis of Crohn's disease and RVF underwent surgical management. Five patients had a vaginal advancement flap (VAF) by Female Pelvic Medicine and Reconstructive Surgery and one patient was treated by the rectal advancement flap by Colorectal Surgery. The failure rate in our study population was 33% (2/6). Of note, two of the patients who had a successful VAF had a previous failure after RAF. In addition, four patients who had a repair via the transvaginal approach had a concomitant pedicled flap procedure (i.e. Martius or gracilis flap). The average follow-up for all our patients was 5 months (+/- 6.5 months). No patients failed if they received a VAF with a concomitant flap procedure.

STUDY DESIGN: Retrospective case series of women (n=6) with Crohn's disease surgically treated with either vaginal or rectal advancement flaps. Demographic information and data specific to Crohn's disease at the time of surgery were collected. In addition, operative reports and postoperative follow-up visits were reviewed.

English