지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.3
- 발행연도
- 2019.9
- 수록면
- 149 - 156 (8page)
이용수
초록· 키워드
오류제보하기
Purpose: Rectovaginal fistula can result from various causes and diverse surgical procedures have developed as a result. We investigated the outcomes of surgical treatments for rectovaginal fistula according to causes and procedures.
Methods: Between 1998 and 2016, 92 patients underwent 128 operations for rectovaginal fistula. Prospectively collected data were recorded, and a retrospective review was conducted.
Results: The median age was 49 years, and low fistula occurred in 58 patients (63.0%). The most common cause was radiation therapy, followed by pelvic operation, birth injury, perineal operation, cancer invasion, and trauma. The most common procedure during the first operation was diverting ostomy alone, followed by transanal rectal advancement flap, sphincteroplasty with perineoplasty, bowel resection, fistulectomy with seton placement, and Martius flap. Thirtyone patients (33.7%) experienced successful closure after the first operation. Repeated operations were performed in 16 patients (17.4%), including gracilis muscle transpositions, stem cell injections, and Martius flaps. The overall success rate was 42.4% (n = 39). Radiation therapy and pelvic operation as cause of fistula were significantly poor prognostic factors (P = 0.010, P = 0.045) and Crohn disease had a tendency for poor prognostic factors (P = 0.058).
Conclusion: Radiation therapy and pelvic operation for cancer were more common causes than birth injury, and these causes of rectovaginal fistula were the most important prognostic factors. An individualized approach and repeated surgeries with complex or newly developed procedures, even among high-risk causes of fistula, may be necessary to achieve successful closure.
Methods: Between 1998 and 2016, 92 patients underwent 128 operations for rectovaginal fistula. Prospectively collected data were recorded, and a retrospective review was conducted.
Results: The median age was 49 years, and low fistula occurred in 58 patients (63.0%). The most common cause was radiation therapy, followed by pelvic operation, birth injury, perineal operation, cancer invasion, and trauma. The most common procedure during the first operation was diverting ostomy alone, followed by transanal rectal advancement flap, sphincteroplasty with perineoplasty, bowel resection, fistulectomy with seton placement, and Martius flap. Thirtyone patients (33.7%) experienced successful closure after the first operation. Repeated operations were performed in 16 patients (17.4%), including gracilis muscle transpositions, stem cell injections, and Martius flaps. The overall success rate was 42.4% (n = 39). Radiation therapy and pelvic operation as cause of fistula were significantly poor prognostic factors (P = 0.010, P = 0.045) and Crohn disease had a tendency for poor prognostic factors (P = 0.058).
Conclusion: Radiation therapy and pelvic operation for cancer were more common causes than birth injury, and these causes of rectovaginal fistula were the most important prognostic factors. An individualized approach and repeated surgeries with complex or newly developed procedures, even among high-risk causes of fistula, may be necessary to achieve successful closure.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Saclarides TJ / 2002 / Rectovaginal fistula / Surg Clin North Am 82:1261~1272
Ozuner G / 1996 / Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal/vaginal fistulas / Dis Colon Rectum 39:10~14
Hannaway CD / 2008 / Current considerations in the management of rectovaginal fistula from Crohn’s disease / Colorectal Dis 10:747~755
Lucarotti ME / 1991 / Surgical management of intestinal radiation injury / Dis Colon Rectum 34:865~869
Rothenberger DA / 1982 / Endorectal advancement flap for treatment of simple rectovaginal fistula / Dis Colon Rectum 25:297~300
Ozuner G / 1996 / Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal/vaginal fistulas / Dis Colon Rectum 39:10~14
Hannaway CD / 2008 / Current considerations in the management of rectovaginal fistula from Crohn’s disease / Colorectal Dis 10:747~755
Lucarotti ME / 1991 / Surgical management of intestinal radiation injury / Dis Colon Rectum 34:865~869
Rothenberger DA / 1982 / Endorectal advancement flap for treatment of simple rectovaginal fistula / Dis Colon Rectum 25:297~300
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UCI(KEPA) : I410-ECN-0101-2019-514-001232740