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Trans-vaginal repair of recurrent rectovaginal fistula with interposition of BIO-A Tissue Reinforcement

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Abstract

Rectovaginal fistulas (RVFs) represent the majority of all symptomatic leakages after anterior and low anterior resection in women. Conservative management is useful in paucisymptomatic patients with small fistulas but is usually unsuccessful in all other cases. The surgical strategies are various and heavily dependent on the type and extent of anatomic involvement. We present a case of a 51-year-old female with a multi-recurrent rectovaginal fistula that occurred since a laparoscopic sigmoidectomy was performed for a complicated diverticular disease in May 2015. An attempt to close the fistula was undertaken three times. In July 2019, a transvaginal repair was performed with interposition in the rectovaginal septum of GORE® BIO-A® Tissue Reinforcement. The postoperative course was uneventful. There was no recurrence and functional outcome was good at 24-months follow-up. Rectovaginal fistula can be successfully treated using the interposition of a GORE® BIO-A® Tissue Reinforcement with significant economic savings and good functional outcomes even through a transvaginal approach. It represents a therapeutic option for an otherwise difficult-to-treat complex fistula.

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Authors and Affiliations

  1. Department of Surgery, San Giovanni Addolorata Hospital Complex, Rome, Italy

    Alessia Fassari, Emanuele Santoro & Marco Maria Lirici

  2. Department of Radiology, San Giovanni Addolorata Hospital Complex, Rome, Italy

    Pasquale Paolantonio

  3. Saint Camillus International University of Health and Medical Sciences (UniCamillus), Rome, Italy

    Marco Maria Lirici

Authors
  1. Alessia Fassari
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  2. Emanuele Santoro
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  3. Pasquale Paolantonio
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  4. Marco Maria Lirici
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Correspondence to Marco Maria Lirici.

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Fassari, A., Santoro, E., Paolantonio, P. et al. Trans-vaginal repair of recurrent rectovaginal fistula with interposition of BIO-A Tissue Reinforcement. Updates Surg 73, 2381–2384 (2021). https://doi.org/10.1007/s13304-021-01179-0

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  • DOI: https://doi.org/10.1007/s13304-021-01179-0

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