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Colorectal Surgery for Deep Endometriosis Infiltrating the Bowel
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Hanan Alsalem, Jean-Jacques Tuech, Damien Forestier, Benjamin Merlot, Myriam Noailles, Horace Roman
In the FRIENDS survey, the rate of rectovaginal fistula in patients managed by disc excision was 3.6%, which was three fold higher than the rate recorded in patients managed by shaving (1.3%) and comparable to segmental resection (3.9%). This rate is similar to that reported by an Australian team in a series enrolling patients managed by disc excision using the circular transanal stapler (24).
Anorectal malformation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Marc A. Levitt, Richard J. Wood
ARMs occur in 1 in 4000 of neonates, slightly more commonly in boys than in girls. The most common defects in girls are a rectovestibular fistula followed by a rectoperineal fistula. A true rectovaginal fistula is rare. Most of the “rectovaginal fistulas” described are probably cases of misdiagnosed cloacas or rectovestibular fistulas. The third most common defect in girls is a cloaca.
Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A colorectal surgeon's perspective
Published in Seema Chopra, Endometriosis, 2020
Major complications include rectovaginal fistulae, anastomotic leak, pelvic abscess, and functional problems. In a review by Meuleman et al. [74], in patients undergoing bowel resection anastomosis, there was a 2.7% incidence of rectovaginal fistulae, a 1.5% incidence of anastomotic leakage, and a 0.34% incidence of pelvic abscess; whereas in the mixed surgical group (shave excision + full-thickness disc excision + bowel resection), the reported incidence of rectovaginal fistulae was 0.7%, anastomotic leakage was 0.7%, and abscess was 0.3%.
Impact of preoperative chemoradiation with higher dose intensity modulated radiotherapy on pathological complete response for locally advanced rectal cancer: a systematic review
Published in Expert Review of Anticancer Therapy, 2022
Roberta Carbonara, Alessia Surgo, Maria Paola Ciliberti, Fabiana Gregucci, Ilaria Bonaparte, Luca Nicosia, Elisa Meldolesi, Morena Caliandro, Valentina Ferraro, Riccardo Inchingolo, Riccardo Memeo, Elena Ludovico, Roberto Calbi, Mariadea Lavalle, Maria Antonietta Gambacorta, Filippo Alongi, Alba Fiorentino
Only two studies report late toxicity data. No differentiation was made between late side effects due to surgery and those due to previous RT, also because this distinction is not always feasible. Engels et al. reported a 6% incidence of ≥ Grade 3 GI late toxicity, which is reduced to 2% at 2 years after the end of treatment, and 4% of ≥G3 genitourinary late toxicity [12]. In particular, among the 102 treated patients, the authors described two cases of Grade 4 toxicity (small bowel obstruction and anal incontinence) and four cases of Grade 3 late toxicity (chronic diarrhea, small bowel obstruction, and anastomotic strictures), not correlated to the SIB-RT. Regarding genitourinary toxicity, three patients developed Grade 4 late effects (incontinence requiring urinary diversion and ureteral stricture requiring ureteronephrectomy). Moreover, 51% of the 47 men sexually active before treatment developed erectile dysfunction after treatment, while one woman presented a Grade 3 vaginal stenosis. Li et al. reported four cases (6.3%) of late effects, including two cases of rectovaginal fistulae and two anastomotic fistulae. Overall, however, late toxicity rates remain low and acceptable [44].
Outcomes of surgical treatments for acquired gynatresia in a tertiary institution in Ibadan, Nigeria
Published in Journal of Obstetrics and Gynaecology, 2022
Oluwasomidoyin Olukemi Bello, Imran Oludare Morhason-Bello, Olatunji Okikiola Lawal, Rukiyat Adeola Abdus-Salam, Ayodele Olukayode Iyun, Oladosu Akanbi Ojengbede
A majority (87.1%) had a one-stage surgical repair. A surgical procedure performed was dissection/excision of fibrotic tissue and serial vaginal dilation (45.2%), skin graft (25.8%), flap graft (16.1%) and sigmoid vaginoplasty (16.1%). Myomectomy was performed simultaneously in 66.7% of the 15 women who presented with co-existing uterine fibroid. Postoperative complications recorded were abnormal vaginal discharge, rectovaginal fistula, recurrent vaginal stenosis and vesicovaginal fistula. One of the two women with recurrent severe stenosis had a repeat surgery (Table 2). Ten (32.3%) women were lost to follow-up at 6 months. Successful correction with vagina length of at least 6 cm and width of 4 cm was achieved in 76.0% of the patients while 24.0% had residual partial stenosis or complete stenosis at 6 to 12 months. Sexual satisfaction rates reported among the women available for followed-up at 6 months and beyond were excellent sexual satisfactory intercourse (22.6%), good sexual satisfactory intercourse (25.8%) while 16.1% and 3.2% of the women had fair sexual satisfactory intercourse and apareunia respectively. Only 23.7% of the 17 women who desired pregnancy achieved conception (Table 3).
Use of Vaginal Reconstructive Surgery in Cervical Cancer Patients to Prevent Vaginal Stump Contracture
Published in Journal of Investigative Surgery, 2021
Zhi Wang, Ang Zeng, Fei Long, Ming Wu, Xian-Jia Tan, Zi-Wen Liu, Xiao-Jun Wang
The reported potential postoperative complications included intestinal obstruction and rectovaginal fistula [31], and the incidence of urethral stricture was less [32]. The wedge resection was recommended for ileal fragment resection, with anastomosis as larger as possible to prevent the occurrence of anastomotic stenosis. The patients were encouraged to get out of bed after surgery to prevent intestinal adhesions and reduce adhesive intestinal obstruction. The adjacent organs such as urethra, bladder, and rectum should be carefully protected during the surgery to avoid rectovaginal fistula. Moreover, open abdominal surgery with direct vision had obvious advantages over laparoscopy [33].