Treatment of Rectovaginal Fistula
Rectovaginal fistula (RVF) is a challenging complication with unsatisfactory success and a significant burden for the patients. With insufficient clinical data due to the rare entity, the present state of treatments for RVFs was reviewed especially form the point of factors to determine management,...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2023-04-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/7/2/7_2023-007/_pdf/-char/en |
| _version_ | 1827959514128711680 |
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| author | Kotaro Maeda Norihito Wada Atsuo Shida |
| author_facet | Kotaro Maeda Norihito Wada Atsuo Shida |
| author_sort | Kotaro Maeda |
| collection | DOAJ |
| description | Rectovaginal fistula (RVF) is a challenging complication with unsatisfactory success and a significant burden for the patients. With insufficient clinical data due to the rare entity, the present state of treatments for RVFs was reviewed especially form the point of factors to determine management, classifications, principle of treatment, conservative and surgical treatments with outcomes. Size, fistula localization and etiology, type of fistula; “simple” or “complex,” status of anal sphincter complex and surrounding tissue, presence or absence of inflammation, presence of diverting stoma, previous attempted repair and radiation therapy, patient's condition with co-morbidities, and surgeon's experience are important factors to determine the management of RVF. The inflammation should initially subside in cases with infection. Starting with conservative surgical options and interposing healthy tissue for complex or recurrent fistulas, invasive procedures will be performed if conservative treatment failed. Conservative treatment may be effective in RVFs with minimal symptoms and should be done for small RVFs for a 36 months usual period. Anal sphincter damage might need a repair of sphincter muscles along with RVF repair. Diverting stoma can initially be constructed in patients with severe symptoms and larger RVFs to relief the patient's pain. Simple fistula is usually indicated for local repair. Local repairs to transperineal and transabdominal approaches can be used for complex RVFs. Interposition of healthy, well-vascularized tissue can be required for more complex fistulas and abdominal procedures for high RVFs. |
| first_indexed | 2024-04-09T15:53:21Z |
| format | Article |
| id | doaj.art-b6c63803ab6e4488bdcfe5c9392b366c |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-04-09T15:53:21Z |
| publishDate | 2023-04-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-b6c63803ab6e4488bdcfe5c9392b366c2023-04-26T00:42:35ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532023-04-0172526210.23922/jarc.2023-0072023-007Treatment of Rectovaginal FistulaKotaro Maeda0Norihito Wada1Atsuo Shida2Department of Surgery, Medical Corporation Kenikukai Shonan Keiiku HospitalDepartment of Surgery, Medical Corporation Kenikukai Shonan Keiiku HospitalDepartment of Surgery, Medical Corporation Kenikukai Shonan Keiiku HospitalRectovaginal fistula (RVF) is a challenging complication with unsatisfactory success and a significant burden for the patients. With insufficient clinical data due to the rare entity, the present state of treatments for RVFs was reviewed especially form the point of factors to determine management, classifications, principle of treatment, conservative and surgical treatments with outcomes. Size, fistula localization and etiology, type of fistula; “simple” or “complex,” status of anal sphincter complex and surrounding tissue, presence or absence of inflammation, presence of diverting stoma, previous attempted repair and radiation therapy, patient's condition with co-morbidities, and surgeon's experience are important factors to determine the management of RVF. The inflammation should initially subside in cases with infection. Starting with conservative surgical options and interposing healthy tissue for complex or recurrent fistulas, invasive procedures will be performed if conservative treatment failed. Conservative treatment may be effective in RVFs with minimal symptoms and should be done for small RVFs for a 36 months usual period. Anal sphincter damage might need a repair of sphincter muscles along with RVF repair. Diverting stoma can initially be constructed in patients with severe symptoms and larger RVFs to relief the patient's pain. Simple fistula is usually indicated for local repair. Local repairs to transperineal and transabdominal approaches can be used for complex RVFs. Interposition of healthy, well-vascularized tissue can be required for more complex fistulas and abdominal procedures for high RVFs.https://www.jstage.jst.go.jp/article/jarc/7/2/7_2023-007/_pdf/-char/enrectovaginal fistulatreatmentrectovaginal repairconservative treatmentsurgery |
| spellingShingle | Kotaro Maeda Norihito Wada Atsuo Shida Treatment of Rectovaginal Fistula Journal of the Anus, Rectum and Colon rectovaginal fistula treatment rectovaginal repair conservative treatment surgery |
| title | Treatment of Rectovaginal Fistula |
| title_full | Treatment of Rectovaginal Fistula |
| title_fullStr | Treatment of Rectovaginal Fistula |
| title_full_unstemmed | Treatment of Rectovaginal Fistula |
| title_short | Treatment of Rectovaginal Fistula |
| title_sort | treatment of rectovaginal fistula |
| topic | rectovaginal fistula treatment rectovaginal repair conservative treatment surgery |
| url | https://www.jstage.jst.go.jp/article/jarc/7/2/7_2023-007/_pdf/-char/en |
| work_keys_str_mv | AT kotaromaeda treatmentofrectovaginalfistula AT norihitowada treatmentofrectovaginalfistula AT atsuoshida treatmentofrectovaginalfistula |