Tsutsumi Norifumi, Yoshida Yasuhiro, Maehara Yoshihiko, Kohnoe Shunji
Department of Surgery, Sawara Hospital, Fukuoka, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1682-3.
The rectovaginal fistula is a rare complication after low anterior resection for rectal cancer, but its management is difficult and the result is often unsatisfactory. Herewith, we report one patient with rectovaginal fistula as a postoperative complication. Rectovaginal fistula appeared on the 23rd day after low anterior resection. Flatus and feces through the vagina were present, but the fistula was too small to be elucidated by gastrografin enema. After 22 days of fasting therapy under total parenteral nutrition, this fistula was closed. The rectovaginal fistula is very rare but is a possible complication after low anterior resection for rectal cancer. Therefore, this complication must be kept in mind, and a minimal-sized fistula can be treated conservatively without a diverting colostomy or other surgical procedures.
直肠阴道瘘是直肠癌低位前切除术后一种罕见的并发症,但其处理困难,结果往往不尽人意。在此,我们报告1例直肠阴道瘘作为术后并发症的患者。直肠阴道瘘在低位前切除术后第23天出现。有气体和粪便经阴道排出,但瘘口太小,无法通过泛影葡胺灌肠明确。在全胃肠外营养支持下进行22天禁食治疗后,此瘘口闭合。直肠阴道瘘非常罕见,但却是直肠癌低位前切除术后可能出现的并发症。因此,必须牢记这一并发症,对于最小尺寸的瘘口可采用保守治疗,而无需行转流性结肠造口术或其他外科手术。