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01-02-2021 | Enterostomy | Original Article

Post surgical rectovaginal fistula: who really benefits from stoma diversion?

Authors: Giuliano Barugola, Elisa Bertocchi, Alessandra Leonardi, Alex M. Almoudaris, Giacomo Ruffo

Published in: Updates in Surgery | Issue 1/2021

Abstract

To analyze the role of stoma diversion and timing of stoma maintenance in the healing of post-surgical Recto Vaginal Fistulae (psRVF). A retrospective analysis of a prospectively maintained registry. All patients with a psRVF diagnosed at IRCCS Sacro Cuore—Don Calabria Hospital of Negrar di Valpolicella from January 2002 to December 2016 were analyzed. The baseline treatment was a fecal diversion. Patients were divided into two groups according to healing time: < 6 months (Group 1) or > 6 months (Group 2). 2043 women underwent rectal resections in the study period. We recorded 37 patients with psRVF (1.8%). Nineteen women (51.3%) healed (Group 1) within 6 months. The median time of psRVF recovery in group 1 was 99.7 days. Concomitant local treatment of the fistula did not influence the healing rate (p 0.8). Colostomies were significantly higher in group 1 (p 0.003). The size of the psRVF influenced the success rate of fistula healing with loop stoma (p 0.07). A multivariate analysis the presence of fever and pelvic abscess (pelvis sepsis) were significantly associated with diversion failure (p 0.035). A step-up approach with the maintenance of loop stoma at least for six months for all patients with psRVF could be changed. Patients with larger fistula and pelvic sepsis at index procedure should be addressed earlier to a specific second-level treatment.

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Title: Post surgical rectovaginal fistula: who really benefits from stoma diversion?
Authors: Giuliano Barugola
Elisa Bertocchi
Alessandra Leonardi
Alex M. Almoudaris
Giacomo Ruffo
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Enterostomy
Rectal Extirpation
Septicemia
Septicemia
Ileostomy
Endometriosis
Enterostomy
Colostomy
Rectal Extirpation
Published in: Updates in Surgery / Issue 1/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00810-w

At a glance: The STEP trials

Springer Medicine

Post surgical rectovaginal fistula: who really benefits from stoma diversion?

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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