Home Page Home Article Read Close close

Original article by Giuseppe Gagliardi MD - Mario Pescatori MD, FRCS (HON), EBSQ
Coloproctology Unit, Villa Flaminia Hospital, Rome, Italy

Clinical and functional results after tailored surgery for rectovaginal fistula



Table 1. – Fistula Etiology.

Etiology

number

(%)

Obstetric

8

(20)

Unknown

8

(20)

Bartholin’s cyst

5

(13)

Crohns

6

(15)

Criptoglandular

3

(7)

Radiotheraphy

3

(7)

Sphincteroplasty

3

(7)

Ulcerative Colitis

2

(5)

STARR*

1

(3)

Hysterectomy

1

(3)

* Stapled transanal rectal resection.


Close close

TABLE 2. – Surgical procedures in 35 operated patients.

Procedure

number

(%)

Sphyncteroplasty

12

(34)

Layered closure

10

(28)

EAF*

5

(14)

Colectomy and coloanal

2

(6)

Omentoplasty

1

(3)

Permanent diversion

1

(3)

Temporary diversion only

1

(3)

Fistulotomy

1

(3)

Ileal resection

1

(3)

Martius flap

1

(3)

* Endorectal advancement flap.

 

Close close

Table 3. – Pescatori’s classification of anal incontinence.

Type of incontinence

Frequency of episodes

A = incontinence to mucus or flatus

1 = sporadic

B = Incontinence to liquids

2 = often

C = Incontinence to solids

3 = always

 



Close close

Table 4. – Variables examined in statistical analysis.

Age

Fistula height

Fistula complexity

Etiology

Type of surgery

Prior RVF surgery

Prior anorectal surgery

Interposition of vascularized tissue*

Concomitant levatorplasty

Temporary diversion

Preoperative continence score

Postoperative continence score

Low manometric pressure

Low rectal volume

TRUS sphincter defects

* External sphincter, levator ani, bulbocavernous muscle

Close close


Table 5. – Postoperative complications. Complications within one month of surgery in 35 operated patients.

Complication

number

(%)

Death

1

(2)

Suture dehiscence

4

10)

Perianal fistula

1

(2)



Close close