Transverse (Tram) rectus abdominis myocutaneous flaps for Rectovaginal and Rectovesical Fistulas Treatment after low Anterior rectal Resection due to Adenocarcinoma

• Authors: Łukasz Krakowczyk , Adam Maciejewski , Janusz Wierzgoń , Ryszard Szumniak , Maciej Grajek , Mirosław Dobrut , Stanisław Półtorak
• Languages of publication: EN

Abstracts

EN

The rectovaginal or rectovesical fistula is a rare complication after low anterior resection for rectal cancer. Treatment is difficult and the result is often unsatisfactory.The aim of this paper was to present results of treatment with transverse rectus abdominis myocutaneous flaps of rectovaginal and rectovesical fistulas as complication of low anterior rectal resection due to adenocarcinoma.Material and methods. We report six patients with rectovaginal or rectovesical fistulas as a postoperative complication after low anterior resection of rectal cancer in Department of Oncological and Reconstructive Surgery in 2006-2008. Transverse rectus abdominis myocutaneous flaps are used for rectovaginal and rectovesical fistulas treatment.Results. In the follow-up period from 4 to 30 months no rectovaginal or rectovesical fistula recurrences and any postoperative complications were noted in all cases.Conclusions. Transverse (TRAM) rectus abdominis myocutaneous flaps are an effective, surgical method for rectovaginal or rectovesical fistulas treatement, especially in patients who recived pre or postoperative radiotherapy.

Keywords

EN

rectal cancer; fistula; pedicle flap

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2010
• Volume: 82
• Issue: 5
• Pages: 279-282

Dates

published

1 - 5 - 2010

online

15 - 9 - 2010

Contributors

author

Łukasz Krakowczyk

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Adam Maciejewski

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Janusz Wierzgoń

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Ryszard Szumniak

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Maciej Grajek

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Mirosław Dobrut

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

author

Stanisław Półtorak

• Department of Oncological and Reconstructive Surgery, Center of Oncology, Institute of Oncology Memorial M. Skłodowska-Curie in Gliwice

References

• Korniluk J, Wcisło G, Nurzyński P i wsp.: Epidemiologia raka jelita grubego. Współczesna Onkologia 2006; 3: 136.
• Tyczyński JE, Wojciechowska U, Didkowska J i wsp.: Atlas umieralności na nowotwory złośliwe w Polsce w latach 1991-1995. Centrum Onkologii-Instytut im. M. Skłodowskiej-Curie Warszawa 1998.
• Janjan NA, Crane CN, Feig BW et al.: Prospective trial of preoperative concomitant boost radiotherapy with continuous infusion 5-fluorouracil for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2000; 47: 713-18.
• Kościński T, Sękowska M: Przetoki odbytniczo-pochwowe. Post N Med 2006; 5: 192-97.
• Tsang CBS, Rothenberger DA: Rectovaginal fistulas, therapeutic options. Surg Clin North Am 1997; 77: 95-114.
• Oomen JW, Spauwen PH, Bleichrodt RP: Guide-line proposal to reconstructive surgery for complex perineal sinus or rectal fistula. Int J Colorectal Dis 2007; 22: 225-30.[WoS]
• Wexner SD, Ruiz DE, Genua J et al.: Gracilis muscle interposition for the treatment of rectourethral, rectovaginal and pouch-vaginal fistulas: results in 53 patients. Ann Surg 2008; 248: 39-43.[WoS]
• Fernandez LR, Pinto I, Maillo C et al. Rectovesical fistula treated by covered self-expanding prothesis: report of a case. Dis Colon Rectum 1999; 42: 812-15.
• Pinedo G, Phillips R: Labial fat pad grafts (modified Martius graft) in complex perianal fistulas. Ann R Coll Surg Engl 1998; 80: 410-12.
• Spauwen PH, Dony J, Kuypers JC: Transabdominal transfer of the caudally based rectus abdominis muscle in complicated pelvic disease. Eur J Plast Surg 2000; 23: 192-94.
• Abbott DE, Halverson AL, Wayne JD et al.: The oblique rectus abdominal myocutaneus flap for complex pelvic wound reconstruction. Dis Colon Rectum 2008; 51: 1237-41.[WoS]

Identifiers

DOI

10.2478/v10035-010-0039-4