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International Urogynecology Journal

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Open Access 01-10-2019 | Enterostomy | Original Article

Surgical repair of rectovaginal fistulas: predictors of fistula closure

Authors: Jihong Fu, Zhonglin Liang, Yilian Zhu, Long Cui, Wei Chen

Published in: International Urogynecology Journal | Issue 10/2019

Abstract

Introduction and hypothesis

We report the clinical outcome of surgical repair for rectovaginal fistula (RVF) carried out by one operative team. We also investigate the predictive factors for fistula healing.

Methods

A retrospective cohort of 63 patients underwent local surgical repair of RVF during January 2008 and December 2017 by one operative group. The clinical features of the patients were reviewed. The association between fistula closure and diverse clinical parameters, including operative method, fistula location, prior repair, and diverting stoma, was analyzed.

Results

Sixty-three consecutive patients underwent 80 local surgical repairs by our surgical team. Forty-five patients eventually healed after an average of 1.22 procedures. The overall success rate per procedure was 71.2%, whereas the closure rate of the first operation was 55.5% (n = 35). The etiology of the fistula did not impact on the success rate of surgical repair. The history of prior repair predicted a lower success rate on both overall procedure (RR = 0.59, 95% CI 0.41–0.85, p = 0.008) and the first repair in our institution (RR = 0.50, 95% CI 0.31–0.80, p = 0.003). There was no difference in closure rate between the stoma group and the non-stoma group. Nevertheless, among the 15 patients who underwent more than one operation in our center, a diverting stoma seemed to be necessary (10 patients healed in the stoma group and none of the patients healed in the non-stoma group, p = 0.02).

Conclusions

History of prior surgical repair is a risk factor for failure. Diverting stoma did not increase the overall closure rate, but it seemed to be necessary for patients in whom the first operation failed.

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Title: Surgical repair of rectovaginal fistulas: predictors of fistula closure
Authors: Jihong Fu
Zhonglin Liang
Yilian Zhu
Long Cui
Wei Chen
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Enterostomy
Enterostomy
Published in: International Urogynecology Journal / Issue 10/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-04082-w

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Surgical repair of rectovaginal fistulas: predictors of fistula closure

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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