Miklos J R, Kohli N
Northside Hospital, Atlanta, Georgia, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 1999;10(6):405-6. doi: 10.1007/s001920050069.
Rectovaginal fistula repair is commonly performed through the vagina. When recurrent fistulae occur, healthy tissue such as a muscle or fat pad may be interposed to facilitate healing and prevent recurrence. A woman developed a postpartum rectovaginal fistula after her third-degree perineal laceration failed to heal completely. Two subsequent fistula repairs were performed, with recurrence following each procedure. The fistula was ultimately repaired by performing a layered closure and interposing a cadaveric dermal allograft between the rectovaginal septum and vaginal epithelium. Allogenic cadaveric graft may be a viable alternative to traditional autologous flaps for the repair of recurrent or complicated rectovaginal fistulae.
直肠阴道瘘修补术通常经阴道进行。当复发性瘘管出现时,可置入肌肉或脂肪垫等健康组织以促进愈合并防止复发。一名女性在三度会阴裂伤未完全愈合后发生了产后直肠阴道瘘。随后进行了两次瘘管修补术,但每次手术后均复发。最终通过分层缝合并在直肠阴道隔与阴道上皮之间置入尸体真皮同种异体移植物修复了瘘管。对于复发性或复杂性直肠阴道瘘的修复,同种异体尸体移植物可能是传统自体皮瓣的可行替代方案。