지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.3
- 발행연도
- 2019.9
- 수록면
- 142 - 148 (7page)
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초록· 키워드
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Purpose: Rectovaginal fistula (RVF) after low anterior resection for rectal cancer is a type of anastomotic leakage. The aim of this study was to find out the difference of leakage, according to RVF presence or absence and to identify the optimal strategy for RVF.
Methods: All female patients who underwent low anterior resection with colorectal anastomosis or coloanal anastomosis (n = 950) were retrospectively analyzed. Patients’ demographics and perioperative outcomes were analyzed between the RVF group and leakage without the RVF (nRVF) group. We performed 4 types of procedures-primary repair, diverting stoma, redo coloanal anastomosis (RCA), and conservative procedure-to treat RVF, and calculated the success rates of each type of procedure.
Results: The leakage occurred in 47 patients (4.9%). Among them, 18 patients (1.9%) underwent an RVF and 29 (3.0%) underwent nRVF. The RVF group received more perioperative radiotherapy (27.8% vs. 3.4%, P < 0.015) and occurred late onset after surgery (181.3 ± 176.4 days vs. 23.2 ± 53.6 days, P < 0.001) more than did the nRVF group. In multivariate analysis for the risk factor of the RVF group, the RVF group was statistically associated with less than 5 cm of anastomosis more than was the no-leakage group. A total of 35 procedures were performed in 18 patients with RVF for treatment. RCA showed satisfactory success rates (85.7%, n = 6) and, primary repair (transanal or transvaginal) showed acceptable success rate (33.3%, n = 8).
Conclusion: After low anterior resection for rectal cancer, RVF was strongly correlated with a lower level of primary tumor location. Among the patients who underwent leakages, receipt of perioperative radiotherapy was significantly high in the RVF group than that of the nRVF group. Additionally, this study suggests that RCA might be considered another successful treatment strategy for RVF.
Methods: All female patients who underwent low anterior resection with colorectal anastomosis or coloanal anastomosis (n = 950) were retrospectively analyzed. Patients’ demographics and perioperative outcomes were analyzed between the RVF group and leakage without the RVF (nRVF) group. We performed 4 types of procedures-primary repair, diverting stoma, redo coloanal anastomosis (RCA), and conservative procedure-to treat RVF, and calculated the success rates of each type of procedure.
Results: The leakage occurred in 47 patients (4.9%). Among them, 18 patients (1.9%) underwent an RVF and 29 (3.0%) underwent nRVF. The RVF group received more perioperative radiotherapy (27.8% vs. 3.4%, P < 0.015) and occurred late onset after surgery (181.3 ± 176.4 days vs. 23.2 ± 53.6 days, P < 0.001) more than did the nRVF group. In multivariate analysis for the risk factor of the RVF group, the RVF group was statistically associated with less than 5 cm of anastomosis more than was the no-leakage group. A total of 35 procedures were performed in 18 patients with RVF for treatment. RCA showed satisfactory success rates (85.7%, n = 6) and, primary repair (transanal or transvaginal) showed acceptable success rate (33.3%, n = 8).
Conclusion: After low anterior resection for rectal cancer, RVF was strongly correlated with a lower level of primary tumor location. Among the patients who underwent leakages, receipt of perioperative radiotherapy was significantly high in the RVF group than that of the nRVF group. Additionally, this study suggests that RCA might be considered another successful treatment strategy for RVF.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
Kosugi C / 2005 / Rectovaginal fistulas after rectal cancer surgery : incidence and operative repair by gluteal-fold flap repair / Surgery 137:329~336
Antonsen HK / 1987 / Early complications after low anterior resection for rectal cancer using the EEA stapling device. A prospective trial / Dis Colon Rectum 30:579~583
Fleshner PR / 1992 / Anastomotic-vaginal fistula after colorectal surgery / Dis Colon Rectum 35:938~943
Matthiessen P / 2010 / Anastomotic-vaginal fistula(AVF)after anterior resection of the rectum for cancer--occurrence and risk factors / Colorectal Dis 12:351~357
Lowry AC / 1988 / Repair of simple rectovaginal fistulas. Influence of previous repairs / Dis Colon Rectum 31:676~678
Antonsen HK / 1987 / Early complications after low anterior resection for rectal cancer using the EEA stapling device. A prospective trial / Dis Colon Rectum 30:579~583
Fleshner PR / 1992 / Anastomotic-vaginal fistula after colorectal surgery / Dis Colon Rectum 35:938~943
Matthiessen P / 2010 / Anastomotic-vaginal fistula(AVF)after anterior resection of the rectum for cancer--occurrence and risk factors / Colorectal Dis 12:351~357
Lowry AC / 1988 / Repair of simple rectovaginal fistulas. Influence of previous repairs / Dis Colon Rectum 31:676~678
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UCI(KEPA) : I410-ECN-0101-2019-514-001232755