Techniques and results for the treatment of anovaginal fistulas in a specialized colorectal unit: OP34


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Abstract

Aim:The ideal technique for the management of anovaginal fistulas is controversial. To analyze techniques and results for the treatment of anovaginal fistulas with regards to recurrence rates.Method:Patients undergoing surgery for anovaginal fistulas from 1994-2010 were included from aprospective colorectal database. The search terms used were anovaginal and low rectovaginal fistulas. The results of the surgical techniques were analyzed together with the risk factors for fistula recurrence.Results:Fifty-four patients [mean age of 45.8 (± 18.56) years] and mean follow-up of 23 months who underwent surgery for rectovaginal fistulas were included. 27 operations were performed in 26 patients who met the inclusion criteria. The most frequent cause was obstetric in 69.2% (18). Core out and rectal mucosal advancement flap was performed in 13 (50%) patients, Corman's operation in 6 (26%), fistulotomy and sphincteroplasty in 5 (19.2%), fistulectomy in 1 (5.6%) and abdominoperineal resection in 1 (5.6%). There was an 84.6% (22)primary cure rate and no significant differences in the number ofprevious surgeries, technique performed and defunctioning colostomy with regards to fistula recurrence. Conclusion:Satisfactory results for the treatment of these complex fistulas can be obtained with specialized treatment and adequate selection of patients and techniques.

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