Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
Tech Coloproctol. 2020 May;24(5):475-478. doi: 10.1007/s10151-020-02185-x. Epub 2020 Mar 25.
Rectovaginal, pouch-vaginal, and recto-urethral fistulas are very challenging to treat. Gracilis muscle interposition was shown be an effective treatment for these complex fistulas. The aim of this study was to investigate the feasibility and outcomes of redo gracilis interposition for persistent and recurrent complex perineal fistulas.
A retrospective analysis of all patients who had redo gracilis muscle interposition for complex perineal fistulas at our institution from 1995 to 2019 was performed.
Nine patients (5 males, mean age 55 years) were included for analysis. The types of fistulas were recto-urethral (n = 5), rectovaginal (n = 2) and pouch-vaginal (n = 2). The success rate was 56% with 5 patients achieving complete healing of the fistula. Only 1 patient (11%) experienced a postoperative complication.
Redo gracilis muscle interposition is feasible and safe with promising resultsin healing of complex perineal fistula.
直肠阴道瘘、直肠阴道旁窦和直肠尿道瘘的治疗极具挑战性。内收肌肌瓣转移术被证明是治疗这些复杂瘘管的有效方法。本研究旨在探讨内收肌肌瓣转移术治疗持续性和复发性复杂会阴瘘的可行性和疗效。
对 1995 年至 2019 年我院行内收肌肌瓣转移术治疗复杂会阴瘘的所有患者进行回顾性分析。
9 例患者（5 例男性，平均年龄 55 岁）纳入分析。瘘管类型为直肠尿道瘘（n=5）、直肠阴道瘘（n=2）和直肠阴道旁窦（n=2）。手术成功率为 56%，5 例患者的瘘管完全愈合。仅 1 例（11%）患者发生术后并发症。
对于复杂会阴瘘，重复行内收肌肌瓣转移术是可行且安全的，具有良好的愈合效果。
