Rectovaginal Fistula After Low Anterior Resection: Prevention and Management

Overview

Journal World J Gastrointest Surg

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2021 Sep 13

PMID 34512900

Citations 5

Authors

Varut Lohsiriwat

Romyen Jitmungngan

Affiliations

Soon will be listed here.

Abstract

Rectovaginal fistula after low anterior resection for rectal malignancy is one of the most challenging postoperative complications because it is difficult to treat and may complicate plans of adjuvant therapy. This problematic complication could lead to multiple operations, stoma formation, sexual dysfunction, fecal incontinence and psychosocial ramifications. This review comprehensively covers an overview of its incidence, risk factors, presentation and evaluation, management (ranging from conservative measures, endoscopic treatment and local tissue repair to radical resection and redo anastomosis) and treatment outcomes of rectovaginal fistula after low anterior resection. Notably, these therapeutic options and outcomes are influenced by several factors, including the size and location of the fistula, tumor clearance, cancer staging, quality of colorectal anastomosis and surrounding tissue, presence of diverting stoma, previous attempted repair, and the surgeon's experience. Also, strategies to prevent rectovaginal fistula after low anterior resection are presented with illustrations. Finally, a decision-making algorithm for managing this complication is proposed.

Citing Articles

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Postoperative rectovaginal fistula: stoma may not be necessary-a French retrospective cohort.

Poitevin M, Hamel J, Ngoma M, Brochard C, Duchalais E, Siproudhis L Tech Coloproctol. 2024; 28(1):138.

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