Tolga ŞAHİN, Osman KURUKAHVECİOĞLU, B.Bülent MENTEŞ, Sezai LEVENTOĞLU, Bülent AYTAÇ, Melike Karen GÜNER

Rektovajinal fistüllerin cerrahi tedavisi-vaka serisi

Bu makalede kliniğimizde rektovajinal fistül (RVF) nedeniyle tedavi edilen dokuz hastanın özellikleri ve uygulanan cerrahi yöntemler bildirilmiştir. 2002 ve 2005 yılları arasında RVF nedeniyle dokuz kadın hastaya çeşitli ameliyatlar uygulandı. Bu hastalarda kullanılan farklı cerrahi yöntemler ve tedavi sonuçları irdelendi. Hastalarımızda RVF oluşumuna en sık yol açan nedenler obstetrik ve perineal-rektal operasyonlar olarak tespit edildi. Gaz inkontinansı ve vajinal kirlenme; hastaların en sık başvuru nedenleriydi. Vakaların farklı özellikleri çerçevesinde yedi farklı cerrahi yönteme gereksinim duyulmuş ve beş hastada cerrahi tedaviye saptırıcı ileostomi/kolostomi eklenmiştir. Vakalarda, intraoperatif ve postoperatif dönemde major bir komplikasyon ve takip süresince nüks ile karşılaşılmamıştır. Rektovajinal fistül, tedavisi zor ve özellikli bir cerrahi hastalıktır. Hastalar pelvik cerrahi alanında uzman ekipler tarafından, çok sayıda cerrahi seçeneğin tümü bilinerek tedavi edilmelidirler.

Surgical treatment of rectovaginal fisting: A case series

To describe the clinical features of a series of nine patients with rectovaginal fistula and report the different surgical approaches. Nine patients were operated on by various surgical approaches for rectovaginal fistula between 2002 and 2005. These various surgical procedures and their results are discussed. Obstetric and prior perineal-rectal surgeries were found to be the most common causes of rectovaginal fistula in our series. Flatus incontinence and vaginal soiling were leading symptoms at admission. Seven different surgical procedures were indicated, and in five patients ileostomy or colostomy was added to the surgical procedures. No major complications were detected, and no recurrences were observed during the follow-up period. The treatment of rectovaginal fistula is difficult and requires special surgical expertise. Patients should be operated on by specialist teams knowledgeable about all possible surgical alternatives.

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