Gracilis muscle interposition for rectovaginal and anovaginal fistula repair: a systematic literature review.
Colorectal Dis
; 17(2): 104-10, 2015 Feb.
Article
en En
| MEDLINE
| ID: mdl-25284745
ABSTRACT
BACKGROUND:
Repair of rectovaginal fistula (RVF) is associated with high recurrence. For this reason gracilis muscle interposition is increasingly being used.AIM:
To evaluate the efficacy of this procedure for RVF repair. METHOD/SEARCH STRATEGY A search of PubMed and Medline databases was performed in November 2013 using the text terms and MESH headings 'rectovaginal fistula/fistulation', and 'gracilis muscle', spanning 1980-2013. The search strategy was restricted to articles written in English with available abstracts. Sample size, aetiology of RVF, previous repair attempts, follow-up period, healing rates and complications were recorded and analysed.RESULTS:
Seventeen studies involving 106 patients were analysed. The cause of RVF included inflammatory bowel disease (n = 37 [34.9%] Crohn's disease [34], ulcerative colitis [3]), pelvic surgery (37 [34.9%]), obstetric injury (9 [8.5%]), malignancy (7 [6.6%]), trauma (5 [4.7%]), miscellaneous (idiopathic, endometriosis, radiation 11 [10.4%]). Patients had undergone a median number of two previous unsuccessful repairs. At a median follow-up of 21 months, healing had occurred in 33-100% (median 100%) with the largest studies reporting rates between 60% and 90%. Thirteen studies did not report any complications, with the remainder reporting only minor morbidity.CONCLUSION:
Gracilis interposition appears to have a reasonable success rate for RVF repair with acceptable morbidity. It may be considered as one of the first-line treatment options for recurrent RVF.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fístula Rectal
/
Fístula Rectovaginal
/
Fístula Vaginal
/
Músculo Esquelético
/
Procedimientos de Cirugía Plástica
Tipo de estudio:
Systematic_reviews
Límite:
Adolescent
/
Adult
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Aged
/
Aged80
/
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Colorectal Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Reino Unido
Pais de publicación:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
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SCOTLAND
/
UK
/
UNITED KINGDOM