| Title |
Graciloplasty of the rectovaginal fistula after chemoradiation followed by total mesorectal excision for rectal cancer: a single centre experience / |
| Another Title |
Rektovaginalinės fistulės plastika m. gracilis po chemospindulinio gydymo ir totalios mezorektinės ekscizijos dėl tiesiosios žarnos vėžio. |
| Authors |
Misenko, Paulius ; Samalavičius, Narimantas Evaldas ; Smolskas, Edgaras |
| DOI |
10.15388/LietChirur.2014.3080 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2014, t. 13, nr. 2, p. 123-126.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
chemoradiation ; graciloplasty ; rectal cancer ; rectovaginal fistula ; total mesorectal excision |
| Abstract [eng] |
Background / objective. Rectovaginal fistula (RVF) is one of the intractable complications following chemoradiation and total mesorectal excision (TME) for rectal cancer. It is supposed that there is a strong possibility of this complication in patients after radiation therapy and having an underlying sepsis. This complication was managed by gracilis muscle transposition. Methods. A retrospectively maintained database was used to identify patients who underwent gracilis muscle transposition for rectovaginal fistula at the Institute of Oncology, Vilnius University from November 2005 to November 2013. Results. Five gracilis muscle transposition were perfomed. Patients mean age was 57.2±17 years. All patients were female. They received neoadjuvant chemoradiation with a total dose of 50 Gy and two cycles of 5-FU + leucovorin and TME with a colonic J-pouch anal stapled anastomosis, and preventive loop ileostomy. All of them developed RVF during three weeks postoperatively. Graciloplasty was performed using the gracilis muscle from the right thigh. The median length of hospital stay was 10 days (9–13). Success was defined as a healed fistula after ileostomy closure, and/or was confirmed by proctoscopy, proctography, negative air–water and methylene blue tests prior to that. In our center, the success rate is 60 percent. Conclusions. Our data confirm that the strategy of gracilis muscle transposition is a useful option for RVF management in such patients as the number of other successful modalities are limited. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
English |
| Publication date |
2014 |
| CC license |
|
