Fujita Shotaro, Momma Tomoyuki, Endo Eisei, Kase Koji, Ujiie Daisuke, Hanayama Hiroyuki, Watanabe Yohei, Okayama Hirokazu, Sakamoto Wataru, Endo Hisahito, Saito Motonobu, Saze Zenichiro, Ohki Shinji, Kono Koji
Dept. of Gastrointestinal Tract Surgery, Fukushima Medical University.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2078-2080.
Although rectovaginal fistula is a rare complication of rectal cancer surgery, it is usually difficult to cure with conservative treatment, and patients generally need surgical intervention. A woman in her 70s underwent laparoscopic low anterior resection with right lateral lymph node dissection for rectal cancer. On postoperative day(POD)6, she had an anastomotic leakage and received conservative treatment. On POD 9, she underwent emergent laparotomy for urinary peritonitis as well as ileostomy and ureteral stenting. On POD 21, the rectovaginal fistula was confirmed with lower gastrointestinal tract fluoroscopic examination. The patient received conservative therapy for the rectovaginal fistula with estriol vaginal tablets and vaginal lavage for 2 weeks. Subsequently, the fistula was completely cured. After continuation of the estriol vaginal tablets for 4 weeks, the rectovaginal fistula has not recurred at the most recent follow-up.
尽管直肠阴道瘘是直肠癌手术罕见的并发症,但保守治疗通常难以治愈,患者一般需要手术干预。一名70多岁的女性因直肠癌接受了腹腔镜低位前切除术及右侧淋巴结清扫术。术后第6天,她出现吻合口漏并接受了保守治疗。术后第9天,她因尿性腹膜炎接受了急诊剖腹探查术,并行回肠造口术和输尿管支架置入术。术后第21天,通过下消化道透视检查确诊为直肠阴道瘘。患者使用雌三醇阴道片并进行阴道灌洗对直肠阴道瘘进行了2周的保守治疗。随后,瘘完全治愈。继续使用雌三醇阴道片4周后,在最近的随访中直肠阴道瘘未复发。