Surgery Today

, Volume 29, Issue 5, pp 443–445 | Cite as

Successful transvaginal repair of a rectovaginal fistula developing after double-stapled anastomosis in low anterior resection: Report of four cases

  • Tohru Nakagoe
  • Terumitsu Sawai
  • Takashi Tuji
  • Atushi Nanashima
  • Hiroyuki Yamaguchi
  • Tohru Yasutake
  • Yoshihiro Ayabe
Case Reports

Abstract

The management of postoperative rectovaginal fistula (RVF) after low anterior resection for rectal cancer is difficult and the results are often unsatisfactory. Among 140 patients with rectal cancer who underwent low anterior resection with a double-stapled anastomosis at our hospital between 1986 and 1996, 4 (2.9%) developed RVF as a post-operative complication. The RVF developed gradually from 9 to 128 days after low anterior resection. We describe herein our technique of using a modified transvaginal approach for RVF repair with a diverting colostomy. In all four patients, the RVFs were completely eradicated with reestablishment of intestinal continuity and did not recur during the mean follwup period of 29.5 months, ranging from 12 to 67 months. This report serves to demonstrate that emerging RVFs secondary to stapled anastomosis in low anterior resection for rectal cancer must be recognized, and that a modified transvaginal approach provides an effective method of repair.

Key Words

rectovaginal fistula rectal cancer low anterior resection double-stapling technique 

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Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • Tohru Nakagoe
    • 1
  • Terumitsu Sawai
    • 1
  • Takashi Tuji
    • 1
  • Atushi Nanashima
    • 1
  • Hiroyuki Yamaguchi
    • 1
  • Tohru Yasutake
    • 1
  • Yoshihiro Ayabe
    • 1
  1. 1.First Department of SurgeryNagasaki University School of MedicineNagasakiJapan

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