MINIMAL-INVASIVE TREATMENT OF HIGH LEVEL RECTOVAGINAL FISTULAS (THE FIRST EXPERIENCE OF «INVAGINATION» METHOD)

Abstract

AIM: to evaluate the efficacy of new «invaginative» method for rectovaginal fistulas. MATERIALS AND METHODS: thirty-seven females aged 37.3 (20-73) years with high rectovaginalfistulas (RVF) were included in the study. All patients underwent fistula surgery using novel «invaginative» method, which includes invagination of the fistula tract into the rectum, RVF origin included inflammatory bowel diseases in 7 (18.9%) patients, delivery injury - in 21 (56.7%), pelvic surgery - in 5 (13.5%), other causes - in 4 (10.8 %). Twenty (54.1 %) patients had two previous unsuccessful repairs on average. Diverting stoma formation as a first stage for RVF repair was performed in 4 (10.8%) patients. Meanfollow-up was 14,7± 6,6 months. RESULTS: «invaginative» method has been performed in all patients. Eight (21.6 %) of them produced recurrence after 2-6 weeks after surgery. No postoperative complications occurred. CONCLUSION: «invaginative» method is a safe and effective in treatment of high rectovaginal fistulas. It can be performed without diverting colostomy in most cases.