Gracilis muscle transposition for treatment of recurrent anovaginal, rectovaginal, rectourethral, and pouch–vaginal fistulas in patients with inflammatory bowel disease
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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).
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.
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).
GMT for the treatment of recurrent and complex anorectal fistulas in patients with IBD patient is eventually successful in almost 2/3 of patients.
KeywordsCrohn disease Fecal incontinence Surgical flaps Surgical stomas
S. Korsun contributed to study design, collected and analyzed the data, and wrote the manuscript. G. Liebig-Hoerl assisted in data collection. A. Fuerst supervised data collection, data analysis, the study, and corrected the paper.
The authors did not receive any funding for this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest in connection with this study.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.