Application Of The Principles And Means Of Plastic Surgery In Repair Of Rectovaginal Fistula

Objective To study application of the principles and means of plastic surgery in repair of rectovaginal fistula and methods of operation.To evaluate the clinical efficacy and feasibility for treatment.Methods Review and analyze advantages and disadvantages of traditional surgical methods of rectovaginal fistula repair in department of general surgery and gynecology and obstetrics.17 patients with rectovaginal fistula were treated with kinds of plastic surgical methods.Ages of them are between 4 to 47.Among them,3 cases are congenital rectovaginal fistula,14 cases are birth trauma,2 cases are high rectovaginal fistula,15 cases are low rectovaginal fistula,14 cases are simples,3 cases are complicated rectovaginal fistula.6 patients were treated with local mucosal flaps, 4 patients were treated with vestibular mucosal flaps,4 patients were treated with pudendal-thigh flaps,3 patients were treated with pudendal-thigh flap pedicled on the obturator artery.On the basis of an anatomical study a new type of the pudendal-thigh flap pedicled on the obturator artery has been designed to repair rectovaginal fistula.Results Since 1995,17 patients with rectovaginal fistula were treated with these plastic surgical methods.All flaps survived and the fistula between vagina and rectum was closed primarily when they discharged from hospital.Follow-upwas 6-12 months,none fail to success after operation. Overall success rate was 100%.Conclusions The advantages of these rectovaginal fistula repair operations,which were,applied principles and means of plastic surgery were proved in clinical cases.These kinds of methods with the clinical promotion value and high primary operative success rate were easy to master.And their surgical indications were more than others.These methods with low incidence of complications could be applied to patients with less age limit.