Tactics of treatment of rectovaginal fistulas

Аннотация

Purpose: to improve the results of treatment of patients with rectovaginal fistulas. Materials and meth-ods: the results of surgical treatment of 23 patients with rectovaginal fistulas were evaluated. Two categories of surgical interventions were applied. 11 patients underwent excision of fistulas followed by layer-by-layer suturing of the surgical wound tightly without the use of sphincterolevatoroplasty components. In the remaining 12 patients, the operation was supplemented by performing segmental proctoplasty, plastic surgery of the vaginal wall with a mobilized mucosubmucosal flap after anterior sphincterolevatoroplasty. Results: 1 recurrence of the disease was registered in the first group of patients. There were no recurrences in the second group of patients. Conclusion: the use of radical excision of the rectovaginal fistula, supplemented by anterior sphincterolevatoroplasty, is the most promising method to reduce the number of postoperative complications and relapses of the disease by restoring the layered structure of the rectovaginal septum.