直肠癌低位前切除术后的直肠阴道瘘经非手术治疗治愈。
Rectovaginal fistula after low anterior resection for rectal cancer healed by nonoperative treatment.
作者信息
Emoto Shigenobu, Nozawa Hiroaki, Yoneyama Satomi, Murono Koji, Kaneko Manabu, Sasaki Kazuhito, Otani Kensuke, Nishikawa Takeshi, Tanaka Toshiaki, Hata Keisuke, Kiyomatsu Tomomichi, Kawai Kazushige, Omata Kanako, Noguchi Tatsuki, Masuda Koichi, Sakata Hiroki, Tajima Yusuke, Hidemura Akio, Suzuki Hiroyuki, Ishimaru Masahiro, Watanabe Toshiaki
机构信息
Department of Surgical Oncology, The University of Tokyo, Japan; Department of Surgery, Kanto Rosai Hospital, Japan.
Department of Surgical Oncology, The University of Tokyo, Japan.
出版信息
Int J Surg Case Rep. 2017;41:121-123. doi: 10.1016/j.ijscr.2017.10.019. Epub 2017 Oct 18.
BACKGROUND
Rectovaginal fistula (RVF) is a serious complication after colorectal anastomosis using a double-stapling technique. RVF following this procedure has been considered to be refractory to conservative treatment.
CASE PRESENTATION
A 75-year-old woman who underwent laparoscopy-assisted low anterior resection for early rectal cancer developed RVF on the 12th postoperative day. Conservative treatment was chosen and was successful. She was discharged from the hospital after 3 weeks with a normal oral diet. Colonoscopy on the 50th postoperative day showed that the RVF was closed.
CONCLUSION
Conservative treatment may be effective for RVF after colorectal anastomosis using a double-stapling technique when there is no evidence of defecation through the vagina.
背景
直肠阴道瘘（RVF）是使用双吻合器技术进行结直肠吻合术后的一种严重并发症。该手术后发生的RVF一直被认为对保守治疗无效。
病例介绍
一名75岁女性因早期直肠癌接受腹腔镜辅助低位前切除术，术后第12天发生RVF。选择保守治疗并取得成功。3周后她出院，饮食正常。术后第50天的结肠镜检查显示RVF已闭合。
结论
当没有经阴道排便的证据时，保守治疗可能对使用双吻合器技术进行结直肠吻合术后的RVF有效。
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