Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Microsurgery. 2011 Oct;31(7):564-7. doi: 10.1002/micr.20923. Epub 2011 Jul 18.
We present a case of successful operative management of an iatrogenic rectourethral fistula with a pedicled vastus lateralis musculofascial flap. The fistula was created during radical prostatectomy operation. During the operation, it was deemed possible to spare this patient from a diverting colostomy and primarily repair a rectal injury. Postoperatively, however, a rectourethral fistula occurred, which was confirmed on retrograde urethrogram. A first attempt failed to close the fistula utilizing the transanal rectal flap advancement technique. A novel technique was attempted using a pedicled vastus lateralis musculofascial flap. This is the first report to our knowledge of repairing a rectourethral fistula with a pedicled vastus lateralis musculofascial flap.
我们报告了一例成功采用带蒂股外侧肌筋膜瓣治疗医源性直肠尿道瘘的病例。该瘘是在根治性前列腺切除术中形成的。在手术中,我们认为有可能避免为该患者行预防性结肠造口术,而直接修复直肠损伤。然而,术后发生了直肠尿道瘘,逆行尿道造影证实了这一点。第一次尝试使用经肛门直肠瓣推进技术未能关闭瘘口。我们尝试了一种新的技术,使用带蒂股外侧肌筋膜瓣。据我们所知,这是首例采用带蒂股外侧肌筋膜瓣修复直肠尿道瘘的报道。