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Outcomes After Repair of Rectovaginal Fistulas Using Bioprosthetics

Ellis, C. Neal M.D.
Diseases of the Colon & Rectum: July 2008
doi: 10.1007/s10350-008-9339-8
Original Contribution: PDF Only

Purpose: Purpose:The purpose of this study was to report the outcomes with the use of advancement flaps and bioprosthetic grafts for the management of rectovaginal fistulas.

Methods: Methods:A retrospective analysis of prospectively collected data was performed for all patients treated with a rectovaginal fistula.

Results: Results:There were 44 patients in the advancement flap group. A mucosal flap repair was performed for 29 patients, and 15 patients had an anodermal flap repair. The mean follow-up was 10 (range, 6-22) months. There were 34 patients in the bioprosthetic repair group. A bioprosthetic interposition graft was used to repair the fistula in 27 patients with a mean follow-up of 12 (range, 6-22) months, and 7 patients had a bioprosthetic plug repair of their fistula with a mean follow-up of 6 (range, 3-12) months. The fistula recurred in 15 patients (34 percent) who were managed by a flap repair, 5 patients (19 percent) who were managed by a bioprosthetic sheet, and 1 patient (14 percent) who was treated with a bioprosthetic plug.

Conclusions: Conclusions:Use of bioprosthetics for the management of rectovaginal fistulas is a new technique, which, based on early experience, seems to yield results equal to advancement flap repair.

Dr. Ellis serves as a paid consultant for Cook Surgical. He has a Research Grant from Cook Surgical to study the long-term efficacy of Cook's Anal Fistula Plug for treatment of anal fistulas.

e-mail: nellis@usouthal.edu

© The ASCRS 2008