Beksac Kemal, Tanacan Atakan, Ozgul Nejat, Beksac Mehmet Sinan
Department of General Surgery, Ankara Oncology Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey.
Obstet Gynecol Int. 2018 May 6;2018:5298214. doi: 10.1155/2018/5298214. eCollection 2018.
To assess the results of the treatment of rectovaginal fistulas with incontinence and impaired anal tonus.
This study comprised three rectovaginal fistula groups that were treated using sphincteroplasty and fistulectomy: group 1: eight women with simple rectovaginal fistula due to birth trauma; group 2: six rectovaginal fistula cases that were associated with chronic inflammatory diseases; and group 3: five cases with at least one failed repair attempt. In the second step, operations that took place before the year 2000 were compared to the operations that took place after the year 2000 in terms of demographic and clinical characteristics.
All of the simple rectovaginal fistula cases healed after the operation. Five of the group 2 patients healed after the operation. However, 1 patient with Crohn's disease needed to undergo reoperation, but successfully healed after 6 months. On the contrary, 3 patients in group 3 healed (60%) whereas 2 of them failed to heal. Clinical characteristics of the patients were different between the groups (before and after the year 2000).
The choice of operation must be done according to the patient's underlying pathology. Proper management of associated inflammatory diseases and systemic disorders is recommended for necessary complex cases.
评估治疗伴有大便失禁和肛门张力受损的直肠阴道瘘的效果。
本研究包括三组采用括约肌成形术和瘘管切除术治疗的直肠阴道瘘患者：第1组：8名因产伤导致单纯直肠阴道瘘的女性；第2组：6例与慢性炎症性疾病相关的直肠阴道瘘病例；第3组：5例至少有一次修复尝试失败的病例。第二步，将2000年前进行的手术与2000年后进行的手术在人口统计学和临床特征方面进行比较。
所有单纯直肠阴道瘘病例术后均愈合。第2组中有5例患者术后愈合。然而，1例克罗恩病患者需要再次手术，但6个月后成功愈合。相反，第3组中有3例患者愈合（60%），而其中2例未愈合。各亚组（2000年前和2000年后）患者的临床特征有所不同。
手术方式的选择必须根据患者的基础病理情况进行。对于必要的复杂病例，建议对相关炎症性疾病和全身性疾病进行适当管理。
