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Perioperative Outcomes of Rectovaginal Fistula Rep ...
Perioperative Outcomes of Rectovaginal Fistula Repair Based on Surgical Approach - John A. Occhino, MD, MS
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Rectovaginal fistulas are abnormal connections between the rectum and vagina that cause the passage of rectal contents into the vaginal canal. Surgical repair is the main treatment for these fistulas and can involve different approaches, such as local repairs, transabdominal repair, or a combination of both.<br /><br />A study was conducted to evaluate the perioperative outcomes of transvaginal/perineal and abdominal approaches to rectovaginal fistula repair. The study found that patients undergoing abdominal repair had higher complication rates, likely due to differences in comorbidities and underlying disease.<br /><br />Among those undergoing transvaginal/perineal repair, factors such as a higher ASA class, disseminated cancer, chronic steroid use, and a low hematocrit were associated with higher postoperative morbidity.<br /><br />The study suggests that this information can be useful for preoperative surgical counseling, as it helps to identify potential risk factors for complications after rectovaginal fistula repair.<br /><br />Rectovaginal fistulas can be caused by various factors, including inflammatory bowel disease, infection, malignancy, pelvic surgery, radiation, or obstetrical trauma. Surgical repair may involve multiple procedures and can include intestinal diversions, flaps, grafts, or other biomaterial for repair.<br /><br />Success rates for rectovaginal fistula repair vary widely, ranging from 43% to 100%, and recurrence rates are not affected by the fistula's underlying cause.<br /><br />Overall, this study provides valuable insights into the perioperative outcomes of different surgical approaches to rectovaginal fistula repair, helping to inform both patients and healthcare providers.
Keywords
Rectovaginal fistulas
abnormal connections
surgical repair
perioperative outcomes
complication rates
risk factors
inflammatory bowel disease
intestinal diversions
success rates
healthcare providers
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