Fistula Research Today is a free monthly online journal that collates and summarizes the latest research about Fistula, including details on types, causes, treatment. | ||||||
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Outcomes after repair of rectovaginal fistulas using bioprosthetics.Ellis CN Department of Surgery, University of South Alabama, Mobile, Alabama, USA. nellis@usouthal.edu PURPOSE: The purpose of this study was to report the outcomes with the use of advancement flaps and bioprosthetic grafts for the management of rectovaginal fistulas. METHODS: A retrospective analysis of prospectively collected data was performed for all patients treated with a rectovaginal fistula. RESULTS: There were 44 patients in the advancement flap group. A mucosal flap repair was performed for 29 patients, and 15 patients had an anodermal flap repair. The mean follow-up was 10 (range, 6-22) months. There were 34 patients in the bioprosthetic repair group. A bioprosthetic interposition graft was used to repair the fistula in 27 patients with a mean follow-up of 12 (range, 6-22) months, and 7 patients had a bioprosthetic plug repair of their fistula with a mean follow-up of 6 (range, 3-12) months. The fistula recurred in 15 patients (34 percent) who were managed by a flap repair, 5 patients (19 percent) who were managed by a bioprosthetic sheet, and 1 patient (14 percent) who was treated with a bioprosthetic plug. CONCLUSIONS: Use of bioprosthetics for the management of rectovaginal fistulas is a new technique, which, based on early experience, seems to yield results equal to advancement flap repair. Published 3 July 2008 in Dis Colon Rectum, 51(7): 1084-8. Articles on Fistula published 3 July 2008: Management of acquired rectourinary fistulas: how often and when is permanent fecal or urinary diversion necessary? Dis Colon Rectum, 51(7): 1049-54. PURPOSE: The objective of this study was to evaluate our experience in the management of acquired rectourinary fistulas at our tertiary center. METHODS: Eighteen patients with fistulas treated from 1999 to 2004 were retrospectively reviewed for demographics, etiology of the fistulas, treatment, and outcome. RESULTS: The median age of the group was 69 years. Sixteen patients had fistulas that were malignant-associated. One patient died from tumor progression before any surgical therapy. The ... [Abstract] [Full-text] Prognostic value of endoanal ultrasound for fistula-in-ano: a retrospective analysis. Dis Colon Rectum, 51(7): 1089-92. PURPOSE: This study was designed to assess whether preoperative endoanal ultrasound plays a prognostic role in the surgical outcome of anal fistula. METHODS: A retrospective review was conducted at a single institution. RESULTS: Sixty-nine patients underwent 83 studies. Indications for endoanal ultrasound included complex fistulas and tracts, multiple external openings, recurrent fistulas, and/or failed previous surgical intervention. Mean age was 51.7 years. Fifty-three patients (77 percent) ... [Abstract] [Full-text] Fistula-associated anal adenocarcinoma: good results with aggressive therapy. Dis Colon Rectum, 51(7): 1061-7. PURPOSE: To evaluate the clinical features, pathology, treatment, and outcome of patients with fistula-associated anal adenocarcinoma. METHODS: We identified 14 patients with histologically proven fistula-associated anal adenocarcinoma. We reviewed their medical records and pathology specimens to characterize their presentation, treatment, and clinical outcome. RESULTS: Nine patients presented with a persistent fistula, 3 with a perianal mass, 1 with pain and drainage, and 1 with a recurrent ... [Abstract] [Full-text] Articles on Fistula published 2 July 2008: Fistula analysis after radial forearm free flap reconstruction of hypopharyngeal defects. Laryngoscope, 118(7): 1157-63. OBJECTIVE/HYPOTHESIS: To evaluate risk factors and management options for fistula formation after hypopharyngeal reconstruction using the radial forearm free flap reconstruction. STUDY DESIGN: Retrospective cohort study. METHODS: Patients undergoing radial forearm free flap for hypopharyngeal reconstruction were retrospectively reviewed. A total of 104 patients underwent this procedure between 2001 and 2007. Fistulas were classified as mild or severe depending on the response to conservative ... [Abstract] [Full-text] Articles on Fistula published 26 June 2008: Gracilis muscle interposition for the treatment of rectourethral, rectovaginal, and pouch-vaginal fistulas: results in 53 patients. Ann Surg, 248(1): 39-43. BACKGROUND: The aim of this study was to review our experience with gracilis muscle interposition for complex perineal fistulas. MATERIAL AND METHODS: A retrospective review of all patients who underwent repair of perineal fistula using the gracilis muscle between 1995 and 2007 was undertaken. Patients were divided into 2 groups according to the fistula type by gender: females (rectovaginal and pouch-vaginal) and males (rectourethral). RESULTS: Gracilis interposition was performed in 53 ... [Abstract] [Full-text] Articles on Fistula published 20 June 2008: Fistula-in-ano: advances in treatment. Am J Surg, 196(1): 95-9. BACKGROUND: Several techniques have been described for the management of fistula-in-ano, but all carry their own risks of recurrence and incontinence. Technology has evolved over the past 2 decades that may enable surgeons to deal with this troublesome issue with greater success. This review summarizes the history of fistula-in-ano management, the current techniques available, and describes new technologies. METHODS: Medline searches were performed using the PubMed, Ovid, Embase, Cochrane, and ... [Abstract] [Full-text] Two-stage pancreatojejunostomy in pancreaticoduodenectomy: a retrospective analysis of short-term results. Am J Surg, 196(1): 3-10. BACKGROUND: The morbidity associated with pancreatic fistula formation after pancreaticoduodenectomy (PD) still remains high. While theoretically 2-stage pancreatojejunostomy (PJ) is effective for preventing pancreatic juice enzymes from becoming activated by enteric contents, its clinical usefulness remains unknown. The aim of this retrospective study was to evaluate the short-term results of two-stage PJ in PD. PATIENTS AND METHODS: In PD cases with a narrow main pancreatic duct and/or soft ... [Abstract] [Full-text] A cautionary note: the use of vacuum-assisted closure systems in the treatment of gastrointestinal cutaneous fistula may be associated with higher mortality from subsequent fistula development. Am J Surg, 196(1): 1-2. During the past several years, vacuum-assisted closure (VAC) systems have been increasingly used in the treatment of gastrointestinal cutaneous fistulas, particularly those associated with open abdomen. Recently, I experienced 2 cases in which the original fistula closed after treatment by the VAC system. However, these patients, who had exposed bowel, developed an additional fistula that required surgery. In a recent article from an intestinal-failure unit in the United Kingdom, Rao et al(1) ... [Abstract] [Full-text] © 2005-2008 Fistula Research Today. All Rights Reserved. |
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