直肠阴道瘘
Rectovaginal Fistulae.
作者信息
Das Bidhan, Snyder Michael
机构信息
Division of Colon and Rectal Surgery, Department of Surgery, University of Texas-Houston, Houston, Texas.
Department of Surgery, University of Texas-Houston, Houston, Texas.
出版信息
Clin Colon Rectal Surg. 2016 Mar;29(1):50-6. doi: 10.1055/s-0035-1570393.
Abstract
Rectovaginal fistulae are abnormal epithelialized connections between the rectum and vagina. Fistulae from the anorectal region to the posterior vagina are truly best characterized as anovaginal or very low rectovaginal fistulae. True rectovaginal fistulae are less common and result from inflammatory bowel disease, trauma, or iatrogenic injury. A very few patients are asymptomatic, but the symptoms of rectovaginal fistula are incredibly distressing and unacceptable. Diagnostic approach, timing, and choice of surgical intervention, including sphincteroplasty, gracilis flaps, Martius flaps, and special circumstances are discussed.
摘要
直肠阴道瘘是直肠与阴道之间异常的上皮化连接。从肛门直肠区域通向阴道后壁的瘘管实际上最好被描述为肛门阴道瘘或极低的直肠阴道瘘。真正的直肠阴道瘘较少见，由炎症性肠病、创伤或医源性损伤引起。极少数患者没有症状，但直肠阴道瘘的症状极其令人痛苦且难以接受。本文讨论了诊断方法、时机以及手术干预的选择，包括括约肌成形术、股薄肌皮瓣、马蒂厄皮瓣以及特殊情况。
相似文献
1
Rectovaginal Fistulae.直肠阴道瘘
Clin Colon Rectal Surg. 2016 Mar;29(1):50-6. doi: 10.1055/s-0035-1570393.
2
Surgical Repair of Rectovaginal Fistula Using the Modified Martius Procedure: A Step-by-Step Guide.经阴道直肠阴道瘘修补术采用改良 Martius 手术：分步指南。
J Minim Invasive Gynecol. 2018 May-Jun;25(4):573-575. doi: 10.1016/j.jmig.2017.08.657. Epub 2017 Sep 6.
3
Bartholin's gland abscess a rare cause of rectovaginal fistula: A case report and literature review.巴氏腺脓肿——直肠阴道瘘的罕见病因：一例病例报告及文献综述
Int J Surg Case Rep. 2021 Sep;86:106344. doi: 10.1016/j.ijscr.2021.106344. Epub 2021 Sep 6.
4
Outcomes of surgical treatments for rectovaginal fistula and prognostic factors for successful closure: a single-center tertiary hospital experiences.直肠阴道瘘手术治疗的结果及成功闭合的预后因素：一家单中心三级医院的经验
Ann Surg Treat Res. 2019 Sep;97(3):149-156. doi: 10.4174/astr.2019.97.3.149. Epub 2019 Aug 29.
5
Gracilis Flap Repair for Reoperative Rectovaginal Fistula.股薄肌皮瓣修复复发性直肠阴道瘘
Dis Colon Rectum. 2023 Jan 1;66(1):113-117. doi: 10.1097/DCR.0000000000002249. Epub 2022 Oct 25.
6
Rectovaginal fistula in Crohn's disease.克罗恩病中的直肠阴道瘘
Dis Colon Rectum. 2007 Dec;50(12):2215-22. doi: 10.1007/s10350-007-9057-7. Epub 2007 Sep 11.
7
Transvaginal Repair of Complex Rectovaginal Fistulas Using the Porcine Urinary Bladder Matrix as an Augmenting Graft.使用猪膀胱基质作为增强移植物经阴道修复复杂直肠阴道瘘
Female Pelvic Med Reconstr Surg. 2017 May/Jun;23(3):e25-e28. doi: 10.1097/SPV.0000000000000410.
8
Transposition of gracilis muscle for treatment of recurrent anal and rectovaginal fistula.股薄肌转位术治疗复发性肛瘘和直肠阴道瘘
Cir Cir. 2009 Jul-Aug;77(4):319-21; 297-9.
9
Martius' flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn's disease, endometriosis and a mullerian anomaly.用于一名患有克罗恩病、子宫内膜异位症和苗勒氏管异常患者的复发性会阴及直肠阴道瘘的马蒂厄皮瓣。
BMC Surg. 2017 Nov 21;17(1):107. doi: 10.1186/s12893-017-0309-8.
10
Surgical repair of rectovaginal fistulas in patients with Crohn's disease.克罗恩病患者的直肠阴道瘘的外科修复。
Eur J Obstet Gynecol Reprod Biol. 2013 Nov;171(1):166-70. doi: 10.1016/j.ejogrb.2013.08.011. Epub 2013 Aug 12.
引用本文的文献
1
Rectovaginal Fistulas, Their Surgical Management, and Outcomes: An Indian Experience.直肠阴道瘘：其手术治疗及结果——印度经验
Cureus. 2025 Jun 19;17(6):e86400. doi: 10.7759/cureus.86400. eCollection 2025 Jun.
2
Epidemiology, etiology and treatment of female vaginal injury.女性阴道损伤的流行病学、病因学及治疗
Reprod Health. 2025 May 6;22(1):65. doi: 10.1186/s12978-025-02017-x.
3
A Gender Perspective on Coloproctological Diseases: A Narrative Review on Female Disorders.结直肠疾病的性别视角：女性疾病的叙述性综述
J Clin Med. 2024 Oct 15;13(20):6136. doi: 10.3390/jcm13206136.
4
Rectovaginal Fistula in a 10-Year-Old With Hirschsprung Disease: A Case Report.一名患有先天性巨结肠症的10岁女童的直肠阴道瘘：病例报告
Cureus. 2024 Mar 31;16(3):e57316. doi: 10.7759/cureus.57316. eCollection 2024 Mar.
5
Rectovaginal Fistulas Not Involving the Rectovaginal Septum Should Be Treated Like Anal Fistulas: A New Concept and Proposal for a Reclassification of Rectovaginal Fistulas.不涉及直肠阴道隔的直肠阴道瘘应像肛瘘一样治疗：直肠阴道瘘重新分类的新概念与提议
Clin Exp Gastroenterol. 2024 Apr 16;17:97-108. doi: 10.2147/CEG.S456855. eCollection 2024.
6
Colovaginal Fistula: An Uncommon Complication After Vaginal Hysterectomy and Pelvic Floor Repair With Mesh Surgery.结肠阴道瘘：阴道子宫切除及盆底网状物修补术后的罕见并发症
Cureus. 2023 Dec 28;15(12):e51221. doi: 10.7759/cureus.51221. eCollection 2023 Dec.
7
Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study.炎症性肠病与瘘管之间的因果关系：来自孟德尔随机化研究的证据。
J Clin Med. 2023 Mar 24;12(7):2482. doi: 10.3390/jcm12072482.
8
Managing non-IBD fistulising disease.非炎症性肠病性瘘管病的管理
Frontline Gastroenterol. 2020 Jul 28;12(6):524-534. doi: 10.1136/flgastro-2019-101234. eCollection 2021.
9
Rectovaginal Fistula With Double Vagina and Anastomotic Stenosis: A Case Report Following Rectal Cancer Surgery.伴有双阴道和吻合口狭窄的直肠阴道瘘：一例直肠癌手术后病例报告
Front Oncol. 2021 Feb 19;11:549211. doi: 10.3389/fonc.2021.549211. eCollection 2021.
10
Establishing a peripartum perineal trauma clinic: a narrative review.建立围产期会阴创伤诊所：叙述性综述。
Int Urogynecol J. 2021 Jul;32(7):1653-1662. doi: 10.1007/s00192-020-04631-8. Epub 2021 Jan 5.
本文引用的文献
1
The disappointing quality of published studies on operative techniques for rectovaginal fistulas: a blueprint for a prospective multi-institutional study.发表的直肠阴道瘘手术技术研究质量令人失望：前瞻性多机构研究蓝图。
Dis Colon Rectum. 2014 Jul;57(7):888-98. doi: 10.1097/DCR.0000000000000147.
2
Martius advancement flap for low rectovaginal fistula: short- and long-term results.Martius 推进皮瓣在低位直肠阴道瘘中的应用：短期和长期疗效。
Colorectal Dis. 2011 Jun;13(6):e112-5. doi: 10.1111/j.1463-1318.2011.02544.x.
3
Comparative study of the house advancement flap, rhomboid flap, and y-v anoplasty in treatment of anal stenosis: a prospective randomized study.肛门狭窄治疗中房式推进皮瓣、菱形皮瓣与 Y-V 成形术的对比研究：一项前瞻性随机研究。
Dis Colon Rectum. 2010 May;53(5):790-7. doi: 10.1007/DCR.0b013e3181d3205a.
4
Fibrin glue in the management of complex anal fistula.纤维蛋白胶在复杂性肛瘘治疗中的应用
Arq Gastroenterol. 2009 Oct-Dec;46(4):300-3. doi: 10.1590/s0004-28032009000400010.
5
Results of combined medical and surgical treatment of recto-vaginal fistula in Crohn's disease.克罗恩病合并会阴直肠瘘的联合医疗和手术治疗结果。
Colorectal Dis. 2011 Jun;13(6):678-83. doi: 10.1111/j.1463-1318.2010.02234.x. Epub 2010 Feb 15.
6
Assessment of the efficacy of the rectovaginal button fistula plug for the treatment of ileal pouch-vaginal and rectovaginal fistulas.评估直肠阴道扣塞治疗回肠袋阴道和直肠阴道瘘的疗效。
Dis Colon Rectum. 2009 Nov;52(11):1877-81. doi: 10.1007/DCR.0b013e3181b55560.
7
Operative results and quality of life after gracilis muscle transposition for recurrent rectovaginal fistula.股薄肌转位治疗复发性直肠阴道瘘的手术结果及生活质量
Dis Colon Rectum. 2009 Jul;52(7):1290-5. doi: 10.1007/DCR.0b013e3181a74700.
8
Gracilis muscle interposition for the treatment of recto-urethral and rectovaginal fistulas: a retrospective analysis of 35 cases.股薄肌植入术治疗直肠尿道瘘和直肠阴道瘘：35例回顾性分析
J Plast Reconstr Aesthet Surg. 2009 Mar;62(3):352-6. doi: 10.1016/j.bjps.2008.11.067. Epub 2009 Jan 21.
9
Use of "house" advancement flap in anorectal diseases.“肛门推进皮瓣术”在肛肠疾病中的应用。
World J Surg. 2008 Oct;32(10):2281-6. doi: 10.1007/s00268-008-9699-1.
10
Gracilis muscle interposition for the treatment of rectourethral, rectovaginal, and pouch-vaginal fistulas: results in 53 patients.股薄肌移植术治疗直肠尿道瘘、直肠阴道瘘和贮袋阴道瘘：53例患者的治疗结果
Ann Surg. 2008 Jul;248(1):39-43. doi: 10.1097/SLA.0b013e31817d077d.
Zotero 插件