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Techniques in Coloproctology
Published in: Techniques in Coloproctology 1/2019

Open Access 01-01-2019 | Azathioprine | Original Article

Gracilis muscle transposition for treatment of recurrent anovaginal, rectovaginal, rectourethral, and pouch–vaginal fistulas in patients with inflammatory bowel disease

Authors: S. Korsun, G. Liebig-Hoerl, A. Fuerst

Published in: Techniques in Coloproctology | Issue 1/2019

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Abstract

Background

The aim of this study was to evaluate the effectiveness of gracilis muscle transposition (GMT) to treat recurrent anovaginal, rectovaginal, rectourethral, and pouch–vaginal fistulas in patients with inflammatory bowel disease (IBD).

Methods

A retrospective study was conducted in patients with IBD who had GMT performed by a single surgeon between 2000 and 2018. Follow-up data regarding healing rate, complications, additional procedures, and stoma closure rate was collected.

Results

A total of 30 women and 2 men had GMT. In all patients fistula was associated with Crohn's disease. In 1 female patient, contralateral gracilis transposition was required after a failed attempt at repair. The primary healing rate was 47% (15/32) and the definitive healing rate (healed by the time of data collection and after secondary procedures) was 71% (23/32). Additional surgical procedures due to fistula persistence or recurrence were performed on 17 patients (53%).At least 7 patients (21%) suffered complications including one wound infection with ischemia of the gracilis muscle. Stoma closure was successful in 18 of 31 cases of patients with stoma (58% of the patients).

Conclusions

GMT for the treatment of recurrent and complex anorectal fistulas in patients with IBD patient is eventually successful in almost 2/3 of patients.
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Metadata
Title
Gracilis muscle transposition for treatment of recurrent anovaginal, rectovaginal, rectourethral, and pouch–vaginal fistulas in patients with inflammatory bowel disease
Authors
S. Korsun
G. Liebig-Hoerl
A. Fuerst
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 1/2019
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-018-1918-7

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