Transvaginal Coloanal Anastomosis after Rectal Resection for the Treatment of a Rectovaginal Fistula Induced by Radiation
I. BrezeanClinical case, no. 6, 2014
Although decreasing in number, radiation induced rectovaginalfistulas are caused by some radiation injuries and chronicischemic lesions. Most of the experienced authors recommendanterior rectal resection with coloanal anastomosis accessedthrough the abdominal-perineum area for high fistula. Wepresent a patient with a fistula that developed 23 years afterhysterectomy and radiotherapy. In this case we performed anabdominal-transvaginal rectal resection with transverse coloplastypouch, coloanal anastomosis and protection ileostomythree months after a terminal sigmoidostomy. The dissection ofthe distal rectum by posteriour colpotomy and coloanal transvaginalanastomosis is a technical variant that may proveadvantageous compared to the procedures featured in theliterature as solutions by rectal resection for rectovaginal fistula.
