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Zeinalpour, Adel, Mohammadi, Armin, Safarpour, Ali Reza, Shojaei-Zarghani, Sara, Shahidinia, Seyede Saeideh, Hosseini, Seyed Vahid. (1404). Repair of Rectovaginal Fistulas with Martius Flap and Concomitant Levatoroplasty: A Ten-year Experience in a Tertiary Center. سامانه مدیریت نشریات علمی, (), -. doi: 10.30476/ijms.2024.103768.3711
Adel Zeinalpour; Armin Mohammadi; Ali Reza Safarpour; Sara Shojaei-Zarghani; Seyede Saeideh Shahidinia; Seyed Vahid Hosseini. "Repair of Rectovaginal Fistulas with Martius Flap and Concomitant Levatoroplasty: A Ten-year Experience in a Tertiary Center". سامانه مدیریت نشریات علمی, , , 1404, -. doi: 10.30476/ijms.2024.103768.3711
Zeinalpour, Adel, Mohammadi, Armin, Safarpour, Ali Reza, Shojaei-Zarghani, Sara, Shahidinia, Seyede Saeideh, Hosseini, Seyed Vahid. (1404). 'Repair of Rectovaginal Fistulas with Martius Flap and Concomitant Levatoroplasty: A Ten-year Experience in a Tertiary Center', سامانه مدیریت نشریات علمی, (), pp. -. doi: 10.30476/ijms.2024.103768.3711
Zeinalpour, Adel, Mohammadi, Armin, Safarpour, Ali Reza, Shojaei-Zarghani, Sara, Shahidinia, Seyede Saeideh, Hosseini, Seyed Vahid. Repair of Rectovaginal Fistulas with Martius Flap and Concomitant Levatoroplasty: A Ten-year Experience in a Tertiary Center. سامانه مدیریت نشریات علمی, 1404; (): -. doi: 10.30476/ijms.2024.103768.3711

Repair of Rectovaginal Fistulas with Martius Flap and Concomitant Levatoroplasty: A Ten-year Experience in a Tertiary Center

Iranian Journal of Medical Sciences
مقالات آماده انتشار، اصلاح شده برای چاپ، انتشار آنلاین از تاریخ 19 فروردین 1404    اصل مقاله (307.6 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2024.103768.3711
نویسندگان
Adel Zeinalpour1، 2؛ Armin Mohammadi3؛ Ali Reza Safarpour4؛ Sara Shojaei-Zarghani4؛ Seyede Saeideh Shahidinia4؛ Seyed Vahid Hosseini* 4
1Department of General Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Clinical Research and Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Background: In the treatment of low- and mid-complex rectovaginal fistulas (RVF), the use of the Martius flap between the vagina and rectum following fistula repair was shown to enhance healing rates. This study reported long-term outcomes from a referral colorectal center, focusing on the use of the Martius flap for managing low- and mid-complex RVFs.
Methods: This study included eligible patients who underwent Martius flap repair at Shahid Faghihi Hospital (Shiraz, Iran), between 2013 and 2023. Continence status and sexual function were assessed using the Cleveland Clinic Incontinence Score (CCIS) and the female sexual function index (FSFI) score. Fistula recurrence was defined as the postoperative passage of gas, feces, or mucosal discharge from the vagina. Statistical analyses were performed using SPSS software. Within-group comparisons were conducted using Wilcoxon signed-rank tests, and between-group analyses were performed using independent samples t tests, Mann–Whitney U tests, and Fisher’s exact tests.  P<0.05 was considered statistically significant.
Results: Of the 27 cases, 37% were classified as low RVF and 63% as mid RVF. Recurrent RVF was observed in 63% of patients, with a median of 2.00 previous fistula surgeries (interquartile range [IQR]=1.50-4.50). After a median follow-up of 48 months (IQR=24.00-84.00), the total success rate was 88.9%. The CCIS significantly decreased postoperatively compared to preoperative levels (P=0.003). Postoperative FSFI scores were within an acceptable range (22.2±4.22). 
Conclusion: The Martius flap procedure was safe, with low morbidity and favorable functional and cosmetic outcomes. It could be considered a first-line treatment option for low- and mid-complex RVFs.
کلیدواژه‌ها
Rectovaginal fistula؛ Surgical procedures, operative؛ Fecal incontinence؛ Sexual dysfunction, physiological
مراجع
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