Martius advancement flap for low rectovaginal fistula: short and long-term results: P010


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Abstract

Aim:Multiple surgical treatments have beenproposed for rectovaginal fistula (RFV) with variable success rate. We aimed to evaluate the short and long-term results of Martius flap in RVF.Method:Twenty females operated between 2000 and 2010 were retrospectively included. Morbidity, success rate, quality of life (SF-12 score), sexual life (FSFI score) and anal continence (Wexner score) were assessed.Results:Major aetiology for RVF was Crohn's disease (n = 8, 40%). Martius advancement flap was harvested from the left side in 14 cases (66.7%). Fourteen patients were diverted, eitherpreviously (n = 10) or at surgery. Morbidity rate was 15% (n = 3). Mean hospital stay was 7.7 days (±3.7). With a mean follow-up of 35 months, seven patients had still a RVF. Success rate was 65%, 50% (4/8) in Crohn's disease. Fifteen patients (75%) answered the three questionnaires. Quality of life was in the first standard deviation with a mean PCS of 46.7 ± 9 and a mean MCS of 44.7 ± 11.3. The median FSFI score was 5 [2-31.7]. Eight patients (53%) healed had normal continence. Wexner score was significantly lower in case of persisting RVF (2.6 ± 5.5) vs (13.4 ± 3.78) (P = 0.0018).Conclusion:In this series Martius flap had acceptable results, with a success rate of 65%.

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