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Techniques in Coloproctology
Published in: Techniques in Coloproctology 5/2020

01-05-2020 | Crohn's Disease | Original Article

Redo gracilis interposition for complex perineal fistulas

Authors: H. Gilshtein, V. Strassman, S. D. Wexner

Published in: Techniques in Coloproctology | Issue 5/2020

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

Redo gracilis muscle interposition is feasible and safe with promising resultsin healing of complex perineal fistula.
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Metadata
Title
Redo gracilis interposition for complex perineal fistulas
Authors
H. Gilshtein
V. Strassman
S. D. Wexner
Publication date
01-05-2020
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 5/2020
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-020-02185-x

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