Repair of radiation-induced rectovaginal fistula with rectal stricture by a combined Tuttle, Turnbull-Cutait and Singapore flap approach.

Updates Surg

Section of Colorectal Surgery, Department of Surgery, New York Medical College, Westchester Medical Center, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.

Published: April 2024

Radiation-induced rectovaginal fistula (RI-RVF) with associated rectal stricture represents a challenging problem in management. The aim of the present technical note is to describe a surgical technique aimed at minimizing disease recurrence by avoiding radiated tissue in the reconstruction: 1. Tuttle longitudinal incision of posterior vaginal wall with sharp excision of proximally located fistula; 2. Resection of strictured rectum via a combined transvaginal/laparotomy access, reconstruction with Turnbull-Cutait colon pull-through, and delayed handsewn coloanal anastomosis with loop ileostomy; 3. Bridge closure of the posterior vaginal wall by the interposition of a Singapore flap. This approach resulted in a favorable outcome at the 1-year follow-up in one patient with a medical history of gynecological carcinoma status after hystero-salpingo-oophorectomy followed by adjuvant radiation.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13304-023-01701-6DOI Listing

Publication Analysis

Top Keywords

radiation-induced rectovaginal
8
rectovaginal fistula
8
rectal stricture
8
singapore flap
8
flap approach
8
posterior vaginal
8
vaginal wall
8
repair radiation-induced
4
fistula rectal
4
stricture combined
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!