Document Detail


Gracilis muscle interposition for the treatment of rectourethral, rectovaginal, and pouch-vaginal fistulas: results in 53 patients.
MedLine Citation:
PMID:  18580205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to review our experience with gracilis muscle interposition for complex perineal fistulas. MATERIAL AND METHODS: A retrospective review of all patients who underwent repair of perineal fistula using the gracilis muscle between 1995 and 2007 was undertaken. Patients were divided into 2 groups according to the fistula type by gender: females (rectovaginal and pouch-vaginal) and males (rectourethral). RESULTS: Gracilis interposition was performed in 53 patients. Seventeen women underwent 19 gracilis interpositions for 15 rectovaginal and 2 pouch-vaginal fistulas; 76% had a mean of (1-4) (mean of 2) prior failed attempt at repair. Eight patients experienced at least one postoperative complication. Two women required a second gracilis interposition. Thirty-three percent of the Crohn's disease-associated fistulas successfully healed; 75% without Crohn's successfully healed.Thirty-six males underwent gracilis interposition for rectourethral fistulas, mainly due to prostate cancer treatment; 13 (36%) had a mean of 1.5 (range 1-3) failed prior repairs. Seventeen patients experienced postoperative complications. The initial success rate in men with rectourethral fistulas was 78%. After successful second procedures in 8 patients, the overall clinical healing rate was 97%. CONCLUSION: The gracilis muscle transposition is a safe and effective method of treating complex perianal fistulas.
Authors:
Steven D Wexner; Dan E Ruiz; Jill Genua; Juan J Nogueras; Eric G Weiss; Oded Zmora
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  248     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2008-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA. deanh@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Crohn Disease / complications
Female
Humans
Male
Middle Aged
Muscle, Skeletal / surgery
Postoperative Complications / epidemiology
Rectal Fistula / etiology,  surgery*
Retrospective Studies
Treatment Outcome
Urethral Diseases / surgery*
Urinary Fistula / surgery*
Vaginal Fistula / etiology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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