Chirurgische Versorgung und Prognose rektovaginaler Fisteln in Abhängigkeit ihrer Genese

Translated title of the contribution: Surgical treatment and prognosis of rectovaginal fistulae according to their origin

E. Schlöricke*, M. Zimmermann, M. Hoffmann, T. Laubert, J. Nolde, P. Hildebrand, H. P. Bruch, R. Bouchard

*Corresponding author for this work
9 Citations (Scopus)


Introduction: The rectovaginal fistula is a rare entity with heterogenic causality. Its genesis seems to predict the extent of operative treatment and the prognostic outcome. The aim of this study was to present different surgical techniques in the treatment of rectovaginal fistulas and their results in correspondence to the genesis. Material and Methods: Between 1 /2000 and 1 /2010, the data of patients with rectovaginal fistulas were collected. The retrospective analysis included biographic and anamnestic data as well as clinical parameters, general and specific complications and postoperative data. Results: In a timespan of ten years 36patients with rectovaginal fistulas were treated. The most common causes were inflammatory diseases (n= 21) and earlier surgical measures (n= 6). Moreover tumour-associated fistulas (n= 5) and fistulas with unknown genesis (n= 4) were seen. As surgical techniques anterior resection (n= 21), transrectal flap plasty (n= 7), subtotal colectomy (n= 3), pelvine exenteration (n= 2) and rectal exstirpation (n= 1) were used. The closure of the vaginal lesion was performed by single suture (n= 25), flap plasty (n= 6), transvaginal omental plasty (n= 2) and posterior vaginal plasty (n= 1). All patients were provided with an omental plasty to perform a safe division of the concerned regions. Patients with a low fistula (< 6 cm) were treated with transperineal omental plasty. The median follow-up was 12months (6 - 36). Within this timespan 6patients suffered from major complications [ARDS, anastomosis insufficiency, postoperative bleeding, recurrence of fistula (n= 3)]. Three patients died in the postoperative period (cerebellar infarct, septic complication associated with Crohn's disease, multiorgan failure in tumour recurrence). Conclusion: The genesis of rectovaginal fistulae is an important predictor for the size of resection which can range from simple excision to exenteration. For optimal therapy the surgical intervention needs to be integrated into an interdisciplinary therapy concept.

Translated title of the contributionSurgical treatment and prognosis of rectovaginal fistulae according to their origin
Original languageGerman
JournalZentralblatt fur Chirurgie - Zeitschrift fur Allgemeine, Viszeral- und Gefäßchirurgie
Issue number4
Pages (from-to)390-395
Number of pages6
Publication statusPublished - 02.04.2012


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