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Tech Coloproctol 2021 Jun 8. Epub 2021 Jun 8.

Division of Colon and Rectal Surgery, University of Illinois at Chicago, 840 S. Wood St., Suite 518E CSB (MC 958), Chicago, USA.

Background: The surgical treatment of rectovaginal fistula (RVF) remains challenging and there is a lack of data to demonstrate the best, single procedure. The aim of this study was to assess the results of different surgical operations for rectovaginal fistula.

Methods: Patients with RVF who underwent surgical repair between 1992 and 2017 at a single, tertiary care center were included. Read More

BMC Surg 2021 Jun 5;21(1):283. Epub 2021 Jun 5.

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Department of General-, Visceral- and Vascular Surgery, Berlin, Germany.

Background: Surgical closure of anal fistulas with rectal advancement flaps is an established standard method, but it has a high degree of healing failure in some cases. The aim of this study was to identify risk factors for anal fistula healing failure after advancement flap placement between patients with cryptoglandular fistulas and patients with Crohn's disease (CD).

Methods: From January 2010 to October 2020, 155 rectal advancement flaps (CD patients = 55, non-CD patients = 100) were performed. Read More

Afr J Reprod Health 2020 Jun;24(2):129-140

Department of Obstetrics, Gynaecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, USA.

Many obstetric fistula patients remain untreated or present late to treatment despite increasing surgical availability in Uga nda. We explored women's perceptions of the cause of their obstetric fistula and their treatment seeking behaviours, including barriers and facilitators to timely care access. In-depth interviews and focus group discussions were conducted from June-August 2014 among 33 women treated for obstetric fistula at Mulago Hospital, Kampala. Read More

BJS Open 2021 May;5(3)

Department of Anaesthesiology/Hyperbaric Medicine, Amsterdam University Medical Centre, location AMC, Amsterdam, the Netherlands.

Background: Positive effects of hyperbaric oxygen (HBO) on perianal fistulas in Crohn's disease (CD) have been described, but the effect on rectovaginal fistulas (RVFs) has not yet been studied. The aim was to investigate the efficacy, safety and feasibility of HBO in patients with RVF in CD.

Methods: In this prospective study, consecutive CD patients between November 2018 and February 2020 presenting with RVF at the outpatient fistula clinic of the Amsterdam University Medical Centre were included and selected to receive treatment with 30 daily HBO sessions, if fistulas were actively draining and any concomitant treatment regimen was stable at least 6 weeks prior to start of HBO. Read More

Front Pediatr 2021 7;9:657251. Epub 2021 May 7.

Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China.

Acquired rectourethral (RUF) or rectovaginal fistulas (RVF) in children are rare conditions in pediatric surgery. Prior literature are retrospective studies and based on a small number of patients. The managements and outcomes vary widely across different studies. Read More

J Minim Invasive Gynecol 2021 May 18. Epub 2021 May 18.

Endometriosis Center, Clinique Tivoli-Ducos, Bordeaux (Drs. Farella and Roman); Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark (Dr. Roman). Electronic address:

Study Objective: To assess the risk of low anterior resection syndrome (LARS) between women managed by either disk excision or rectal resection for low rectal endometriosis.

Design: Retrospective study of a prospective database.

Setting: University hospital. Read More

Dis Colon Rectum 2021 May 20. Epub 2021 May 20.

Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara Provincial Unique Laboratory Department, University Hospital Ferrara, Italy Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara, Ferrara, Italy.

Background: Mesenchymal stem cells derived from adipose tissue have been successfully used to promote sphincter-saving anal fistula healing.

Objective: The aim of this study was to evaluate the efficacy and safety of the use of autologous centrifuged adipose tissue in the healing process of cryptoglandular complex anal fistulas.

Design: Randomized controlled trial. Read More

Tech Coloproctol 2021 May 15. Epub 2021 May 15.

Khonkaen Hospital, Khonkaen, Thailand.

Int J Gynaecol Obstet 2021 May 10. Epub 2021 May 10.

Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Objective: To assess function and disability among women in Rwanda and Democratic Republic of Congo living with fistula and identify characteristics associated with higher disability scores.

Methods: Women presenting for fistula care were recruited. Eligible participants underwent a physical examination to classify fistula type and completed the WHO Disability Assessment Schedule 2. Read More

BMC Gastroenterol 2021 May 8;21(1):206. Epub 2021 May 8.

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.

Background: Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease, and few cases combine with Crohn's disease. We present the first SLE patient concurrent with Crohn's disease and rectovaginal fistula. She was successfully treated with vedolizumab and surgical intervention. Read More

Colorectal Dis 2021 May 6. Epub 2021 May 6.

Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Aim: Injection of Permacol collagen paste can be used as a sphincter-sparing treatment for perianal fistulas. In a tertiary referral population we aimed to evaluate the efficacy of Permacol injection and the clinical and fistula-related factors associated with recurrence.

Method: This was a retrospective analysis of consecutive patients with perianal fistulas treated with Permacol injection at a specialist centre between June 2015 and April 2019. Read More

Clin Case Rep 2021 Apr 23;9(4):2099-2104. Epub 2021 Feb 23.

Department of Radiation Oncology Gunma University Graduate School of Medicine Gunma Japan.

Bevacizumab is a monoclonal antibody against vascular endothelial growth factor that exerts antitumor effect by preventing tumor angiogenesis. Gastrointestinal fistula is a common side effect of bevacizumab in combination with radiotherapy. This case of rectovaginal fistula indicates that the side effect may be unpredictable by the conventional dose-volume parameters for the rectum. Read More

Wounds 2021 Jan;33(1):E10-E13

Shimane University, Shimane, Japan.

Introduction: Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina.

Case Report: A 61-year-old female patient was admitted to the authors' hospital with swelling, extending from the left thigh to the left lower abdomen and crepitus. An axial computed tomography scan showed air in the soft tissue of the left thigh, left buttock, perineal region, and left lower abdomen. Read More

World J Gastroenterol 2021 Apr;27(14):1451-1464

Department of Coloproctology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.

Background: Currently, rectovaginal fistula (RVF) continues to be a surgical challenge worldwide, with a relatively low healing rate. Unclosed intermittent suture and poor suture materials may be the main reasons for this.

Aim: To evaluate the efficacy and safety of stapled transperineal repair in treating RVF. Read More

J Gynecol Obstet Hum Reprod 2021 Apr 19;50(9):102151. Epub 2021 Apr 19.

Department of Gynecology and Obstetrics, Femme Mère Enfant University Hospital, 59 Boulevard Pinel, 69677 Lyon-Bron, France; Claude Bernard University Lyon 1, avenue Rockfeller, 69008 Lyon, France.

Obstetrical anal sphincter injury (OASIS) may lead to significant comorbidities, including anal incontinence, rectovaginal fistula, and pain. A correct repair is required to avoid improper healing, as a persistent defect in the external anal sphincter after delivery can increase the risk of complications and worsening of symptoms following subsequent vaginal deliveries. Herein is described the surgical repair technique for a fourth degree perineal tear. Read More

Colorectal Dis 2021 Apr 14. Epub 2021 Apr 14.

Department of Colorectal Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University of Paris, Clichy, France.

Aim: Graciloplasty (GP) is indicated in the case of recurrent rectovaginal fistula (RVF) after failure of previous local treatments. The aim of this study was to assess risk factors for GP failure performed for RVF.

Methods: This is a retrospective study based on a prospective database on GP, coming from two expert centres. Read More

Plast Reconstr Surg Glob Open 2021 Mar 26;9(3):e3188. Epub 2021 Mar 26.

Department of Colorectal Surgery, University Hospitals Birmingham , Birmingham, United Kingdom.

Eur J Surg Oncol 2021 Mar 22. Epub 2021 Mar 22.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China. Electronic address:

Objective: To compare the oncological outcomes and major complications of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer (FIGO 2009) with a tumour size less than 2 cm.

Methods: We retrospectively compared the oncological outcomes and major complications of 1207 stage IB1 cervical cancer patients with a tumour size less than 2 cm who received LRH (n = 546) or ARH (n = 661) in 37 hospitals.

Results: (1) There was no significant difference in 3-year overall survival (OS; 97. Read More

Khirurgiia (Mosk) 2021 (4):39-45

Pirogov Russian National Research Medical University, Moscow, Russia.

Objective: To evaluate the long-term results of surgical correction of H-type fistula in girls with a normal anus.

Material And Methods: There were 7 patients with rectovestibular fistula and 3 patients with rectovaginal fistula with a normal anus were observed from 2014 to 2019 in the Surgical Department No. 1 of the Russian Children's Clinical Hospital. Read More

Int J Colorectal Dis 2021 Jul 23;36(7):1455-1460. Epub 2021 Mar 23.

Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Aim: Bowel movements after reconstructive anorectal surgery may negatively affect surgical outcome. This study was aimed to assess any differences between a standard diet (SD) and the enteral resorbable diet (ED) in terms of operative outcomes and patient tolerance after fistulectomy with primary sphincter reconstruction.

Method: Adult patients undergoing elective fistulectomy with primary sphincter reconstruction for anorectal and rectovaginal fistulas were eligible for inclusion. Read More

Surg Case Rep 2021 Mar 16;7(1):68. Epub 2021 Mar 16.

Department of Comprehensive Surgery, Shiga University of Medical Science, Seta-tsukinowa cho, Otsu, Shiga, 520-2192, Japan.

Background: Rectovaginal fistula (RVF) after low anterior resection for rectal cancer is troublesome and refractory. Although various surgical procedures have been previously described, no definitive procedure has shown a satisfactory outcome. We present two consecutive Japanese patients who underwent successful surgery for an RVF after low anterior resection. Read More

Aliment Pharmacol Ther 2021 05 15;53(10):1064-1079. Epub 2021 Mar 15.

Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Parkville, Vic., Australia.

Background: Crohn's disease is an inflammatory, penetrating intestinal disease associated with fistula formation. Fistulae in Crohn's disease can be classified into external and internal fistulae. Internal fistulae form between the gastrointestinal tract and another internal organ and include enteroenteric, enterocolic, enterovesical and rectovaginal fistulae. Read More

Front Oncol 2021 19;11:549211. Epub 2021 Feb 19.

Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Rectovaginal fistula (RVF) occurs as a result of abnormal epithelialized connections between the rectum and vagina. Rectal cancer surgery remains the major cause of RVF. Here, we report a rare postoperative complication in which a patient with a double uterine and vagina received RVF following rectal cancer surgery. Read More

Ann Med Surg (Lond) 2021 Feb 28;62:440-445. Epub 2021 Jan 28.

Department of General Surgery, Colorectal Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Aim: Technical difficulties are usually reported in low rectal cancer (LRC) surgery. Moreover inadvertent surgical errors could happen mostly due to lack of experience of the assisting surgeons. Unfortunately, these errors may end up with raising a permanent stoma. Read More

Afr J Paediatr Surg 2021 Jan-Mar;18(1):67-71

Department of Pediatric Surgical Superspecialties, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Background: Constipation is a common problem after surgery for anorectal malformations (ARMs), especially in patients having preserved rectosigmoid after pull-down surgery. Here, we present our experience with patients having constipation after surgery for ARMs and briefly discuss its management.

Materials And Methods: We retrospectively reviewed electronic operative and follow-up data from January 2015 to December 2019 of all patients having constipation after surgery for ARMs. Read More

BMC Womens Health 2021 02 5;21(1):52. Epub 2021 Feb 5.

Department of Obstetrics and Gynaecology, University Hospital Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany.

Background: Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.

Methods: Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively. Read More

Clin Colon Rectal Surg 2021 Jan 22;34(1):28-39. Epub 2020 Sep 22.

Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

Rectovaginal fistula (RVF), defined as any abnormal connection between the rectum and the vagina, is a complex and debilitating condition. RVF can occur for a variety of reasons, but frequently develops following obstetric injury. Patients with suspected RVF require thorough evaluation, including history and physical examination, imaging, and objective evaluation of the anal sphincter complex. Read More

Arch Plast Surg 2021 Jan 15;48(1):127-130. Epub 2021 Jan 15.

Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.

Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. Read More

Pediatr Surg Int 2021 Apr 21;37(4):431-435. Epub 2021 Jan 21.

Children's Hospital Colorado, International Center for Colorectal and Urogenital Care, 13123 East 16th Avenue, Box 323, Anschutz Medical Campus, Aurora, CO, 80045, USA.

Purpose: After treating many adopted patients with congenital colorectal conditions, our goal was to understand if parents were properly counseled about their child's medical needs before adoption.

Methods: A comprehensive questionnaire was developed. Recruitment occurred by social media and colorectal database. Read More

Minerva Chir 2021 Jan 12. Epub 2021 Jan 12.

Colorectal Unit, Department of General and Digestive Surgery, Parc Taulí University Hospital, Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Spain.

Introduction: Transanal endoscopic microsurgery (TEM) is a safe procedure and the rates of intra- and post-operative complications are low. The information in the literature on the management of these complications is limited, and so their importance may be either under- or overestimated (which may in turn lead to under- or overtreatment). The present article reviews the most relevant series of TEM procedures and their complications and describes various approaches to their management. Read More