Endoscopic placement of self-expandable metal stents for treatment of rectovaginal fistulas after colorectal resection for cancer

摘要

A postoperative rectovaginal fistula is a rare adverse event after colorectal resection for cancer.1'2'3 In these clinical situations, the most common etiology derives from a pelvic abscess, determined by a leaking anastomosis, which drains externally through the posterior wall of the vagina. The first issue is to exclude recurrent cancer as the cause of the fistula. Repair through the anus4'5 is successful when the tissue looks normal and is pliable, but this is rarely the case. Sometimes, a flap should be transposed between the vagina and the rectum, by using a muscle like the gracilis or the labium majus (associated or not to the overlying skin and/or to the underlying bulbo-cavernous muscle—so-called Martius flap).