Minimally invasive perineal redo surgery for rectovesical and rectovaginal fistulae: A case series.
Case series
Minimally invasive
Perineal redo surgery
Rectovaginal fistula
Rectovesical fistula
SILS
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
10
2020
revised:
11
11
2020
accepted:
11
11
2020
entrez:
5
1
2021
pubmed:
6
1
2021
medline:
6
1
2021
Statut:
ppublish
Résumé
Iatrogenic recto-urogenital fistulae are refractory complications that rarely heal without surgical intervention. The ongoing local infection causes pain, discomfort and substantially impacts quality of life. Surgical repair requires adequate exposure and space to fill with healthy tissue, which is a major challenge in pelvic redo surgery. An abdominal approach to repair the fistula is associated with major morbidity and often fails to expose the deep pelvis. In our experience a novel transperineal minimally invasive approach a utilizing single incision laparoscopic surgery (SILS) technique could offer improved results. In the present study, three cases of patients with recto-urogenital fistulae after pelvic surgery are described. Two patients were diagnosed with a rectovesical fistula and one patient with a rectovaginal fistula. In all three cases, a minimally invasive perineal approach, using a SILS port, was used to perform surgical repair. The closure of the fistulae involved: a separate repair of the urethra/bladder or vaginal defect and the rectal defect, followed by interposition of vascularized tissue by either a pudendal thigh fasciocutaneous flap or omentoplasty. This study is the first to report on a minimally invasive perineal approach, utilizing a SILS technique for recto-urogenital fistulae repair after previous pelvic surgery. The current approach improves exposure, creates surgical space, optimizes view and allows the interposition of vascularized tissue, without causing substantial blood loss and avoiding major abdominal surgery.
Identifiants
pubmed: 33395885
pii: S2210-2612(20)31090-7
doi: 10.1016/j.ijscr.2020.11.067
pmc: PMC7724097
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
733-738Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Tech Coloproctol. 2006 Jul;10(2):125-30; discussion 130
pubmed: 16773287
Ann Coloproctol. 2014 Feb;30(1):35-41
pubmed: 24639969
J Urol. 2008 May;179(5):1882-6
pubmed: 18353391
Int J Surg. 2016 Jan;25:114-7
pubmed: 26700197
Dis Colon Rectum. 1982 May-Jun;25(4):297-300
pubmed: 7083973
Dis Colon Rectum. 2016 Dec;59(12):1117-1133
pubmed: 27824697
Asian J Urol. 2018 Jul;5(3):149-154
pubmed: 29988864
Surgery. 2005 Mar;137(3):329-36
pubmed: 15746788
Dis Colon Rectum. 1988 Sep;31(9):676-8
pubmed: 3168676
Oncotarget. 2017 Apr 11;8(42):73123-73132
pubmed: 29069855
Am J Surg. 1997 Mar;173(3):213-7
pubmed: 9124629
Int J Surg. 2018 Dec;60:279-282
pubmed: 30359781
Ger Med Sci. 2012;10:Doc15
pubmed: 23255878
Int J Colorectal Dis. 2011 Nov;26(11):1463-7
pubmed: 21701809
Dis Colon Rectum. 2002 Dec;45(12):1622-8
pubmed: 12473885
J Urol. 2010 Feb;183(2):608-12
pubmed: 20018317
J Anus Rectum Colon. 2018 Jul 30;2(3):103-109
pubmed: 31559351
Surg Laparosc Endosc Percutan Tech. 2015 Oct;25(5):384-91
pubmed: 25730741
Dis Colon Rectum. 2017 Jan;60(1):126-127
pubmed: 27926566
Tech Coloproctol. 2014 Sep;18(9):775-88
pubmed: 24848524
Ann Surg. 2015 Feb;261(2):221-7
pubmed: 25185463
Female Pelvic Med Reconstr Surg. 2015 May-Jun;21(3):123-8
pubmed: 25730438
Am J Surg. 1990 May;159(5):514-7
pubmed: 2334017