LinkedIn

 آمار

تعداد نشریات20
تعداد شماره‌ها1,196
تعداد مقالات10,900
تعداد مشاهده مقاله73,730,723
تعداد دریافت فایل اصل مقاله28,152,959
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, 50(6), 416-422. 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, 50, 6, 1404, 416-422. 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, 50(6), pp. 416-422. 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; 50(6): 416-422. 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
مقاله 6، دوره 50، شماره 6، شهریور 2025، صفحه 416-422    اصل مقاله (360.42 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.

تازه های تحقیق

Adel Zeinalpour (Google Scholar)

Seyed Vahid Hosseini (Google Scholar)

کلیدواژه‌ها
Rectovaginal fistula؛ Surgical procedures, operative؛ Fecal incontinence؛ Sexual dysfunction, physiological
مراجع
  1. Reichert M, Schwandner T, Hecker A, Behnk A, Baumgart-Vogt E, Wagenlehner F, et al. Surgical Approach for Repair of Rectovaginal Fistula by Modified Martius Flap. Geburtshilfe Frauenheilkd. 2014;74:923-7. doi: 10.1055/s-0034-1383149. PubMed PMID: 25364031; PubMed Central PMCID: PMCPMC4210382.
  2. Ommer A, Herold A, Berg E, Furst A, Schiedeck T, Sailer M. German S3-Guideline: rectovaginal fistula. Ger Med Sci. 2012;10:15. doi: 10.3205/000166. PubMed PMID: 23255878; PubMed Central PMCID: PMCPMC3525883.
  3. Trovik J, Thornhill HF, Kiserud T. Incidence of obstetric fistula in Norway: a population-based prospective cohort study. Acta Obstet Gynecol Scand. 2016;95:405-10. doi: 10.1111/aogs.12845. PubMed PMID: 26713965.
  4. Zelga P, Tchorzewski M, Zelga M, Sobotkowski J, Dziki A. Radiation-induced rectovaginal fistulas in locally advanced gynaecological malignancies-new patients, old problem? Langenbecks Arch Surg. 2017;402:1079-88. doi: 10.1007/s00423-016-1539-4. PubMed PMID: 27987097; PubMed Central PMCID: PMCPMC5660831.
  5. Schloericke E, Zimmermann M, Benecke C, Laubert T, Meyer R, Bruch HP, et al. Surgical management of complicated rectovaginal fistulas and the role of omentoplasty. Tech Coloproctol. 2017;21:945-52. doi: 10.1007/s10151-017-1657-1. PubMed PMID: 29196958.
  6. Yin HQ, Wang C, Peng X, Xu F, Ren YJ, Chao YQ, et al. Clinical value of endoluminal ultrasonography in the diagnosis of rectovaginal fistula. BMC Med Imaging. 2016;16:29. doi: 10.1186/s12880-016-0131-2. PubMed PMID: 27053063; PubMed Central PMCID: PMCPMC4823858.
  7. Corte H, Maggiori L, Treton X, Lefevre JH, Ferron M, Panis Y. Rectovaginal Fistula: What Is the Optimal Strategy?: An Analysis of 79 Patients Undergoing 286 Procedures. Ann Surg. 2015;262:855-60. doi: 10.1097/SLA.0000000000001461. PubMed PMID: 26583676.
  8. Venara A, Trilling B, Ngoma M, Brochard C, Duchalais E, Siproudhis L, et al. Ano-rectovaginal fistula after obstetrical anal sphincter injury: Diverting stoma does not improve the surgical results. Colorectal Dis. 2022;24:1371-8. doi: 10.1111/codi.16211. PubMed PMID: 35656842; PubMed Central PMCID: PMCPMC9796529.
  9. Kniery KR, Johnson EK, Steele SR. Operative considerations for rectovaginal fistulas. World J Gastrointest Surg. 2015;7:133-7. doi: 10.4240/wjgs.v7.i8.133. PubMed PMID: 26328032; PubMed Central PMCID: PMCPMC4550839.
  10. Ryoo SB, Oh HK, Ha HK, Han EC, Kwon YH, Song I, et al. Outcomes of surgical treatments for rectovaginal fistula and prognostic factors for successful closure: a single-center tertiary hospital experiences. Ann Surg Treat Res. 2019;97:149-56. doi: 10.4174/astr.2019.97.3.149. PubMed PMID: 31508396; PubMed Central PMCID: PMCPMC6722290.
  11. Chitrathara K, Namratha D, Francis V, Gangadharan VP. Spontaneous rectovaginal fistula and repair using bulbocavernosus muscle flap. Tech Coloproctol. 2001;5:47-9. doi: 10.1007/pl00012124. PubMed PMID: 11793261.
  12. McNevin MS, Lee PY, Bax TW. Martius flap: an adjunct for repair of complex, low rectovaginal fistula. Am J Surg. 2007;193:597-9. doi: 10.1016/j.amjsurg.2007.01.009. PubMed PMID: 17434363.
  13. Dindo D. The Clavien–Dindo classification of surgical complications. Treatment of postoperative complications after digestive surgery. 2014:13-7. doi: 10.1007/978-1-4471-4354-3_3.
  14. Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, et al. Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum. 2000;43:9-16. doi: 10.1007/BF02237236. PubMed PMID: 10813117.
  15. Meston CM, Freihart BK, Handy AB, Kilimnik CD, Rosen RC. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med. 2020;17:17-25. doi: 10.1016/j.jsxm.2019.10.007. PubMed PMID: 31735616.
  16. Heydari M, Faghihzadeh S. The female sexual function index (FSFI): validation of the Iranian version. Payesh (Health Monitor). 2008;7.
  17. Zhu YF, Tao GQ, Zhou N, Xiang C. Current treatment of rectovaginal fistula in Crohn’s disease. World J Gastroenterol. 2011;17:963-7. doi: 10.3748/wjg.v17.i8.963. PubMed PMID: 21448347; PubMed Central PMCID: PMCPMC3057157.
  18. Trompetto M, Realis Luc A, Novelli E, Tutino R, Clerico G, Gallo G. Use of the Martius advancement flap for low rectovaginal fistulas. Colorectal Dis. 2019;21:1421-8. doi: 10.1111/codi.14748. PubMed PMID: 31260184.
  19. Tozer PJ, Balmforth D, Kayani B, Rahbour G, Hart AL, Phillips RK. Surgical management of rectovaginal fistula in a tertiary referral centre: many techniques are needed. Colorectal Dis. 2013;15:871-7. doi: 10.1111/codi.12114. PubMed PMID: 23331635.
  20. Matthiessen P, Hansson L, Sjodahl R, Rutegard J. Anastomotic-vaginal fistula (AVF) after anterior resection of the rectum for cancer--occurrence and risk factors. Colorectal Dis. 2010;12:351-7. doi: 10.1111/j.1463-1318.2009.01798.x. PubMed PMID: 19220383.
  21. Dimova A, Erceg Ivkosic I, Brlek P, Dimov S, Pavlovic T, Bokun T, et al. Novel Approach in Rectovaginal Fistula Treatment: Combination of Modified Martius Flap and Autologous Micro-Fragmented Adipose Tissue. Biomedicines. 2023;11. doi: 10.3390/biomedicines11092509. PubMed PMID: 37760949; PubMed Central PMCID: PMCPMC10525900.
  22. Gottgens KW, Smeets RR, Stassen LP, Beets G, Breukink SO. The disappointing quality of published studies on operative techniques for rectovaginal fistulas: a blueprint for a prospective multi-institutional study. Dis Colon Rectum. 2014;57:888-98. doi: 10.1097/DCR.0000000000000147. PubMed PMID: 24901691.
  23. Faur FI, Suciu P, Barbulescu CF, Clim A, Nati I, Lazar G. Modified Martius Flap for repair of a postradiation Rectovaginal Fistula (RVF). A case report. Int J Clin Case Rep Rev. 2022;12:2690-4861. doi: 10.31579/2690-4861/251.
  24. Pitel S, Lefevre JH, Parc Y, Chafai N, Shields C, Tiret E. Martius advancement flap for low rectovaginal fistula: short- and long-term results. Colorectal Dis. 2011;13:e112-5. doi: 10.1111/j.1463-1318.2011.02544.x. PubMed PMID: 21564462.
  25. Lambertz A, Luken B, Ulmer TF, Bohm G, Neumann UP, Klink CD, et al. Influence of diversion stoma on surgical outcome and recurrence rates in patients with rectovaginal fistula - A retrospective cohort study. Int J Surg. 2016;25:114-7. doi: 10.1016/j.ijsu.2015.12.005. PubMed PMID: 26700197.
آمار
تعداد مشاهده مقاله: 153
تعداد دریافت فایل اصل مقاله: 150


سامانه مدیریت نشریات علمی. قدرت گرفته از سیناوب