Onkologie. 2016:10(2):87-90 | DOI: 10.36290/xon.2016.020

Rectovaginal fistula as a complication of surgical treatment in patients with rectal cancer

Libor Ševčík¹, Petra Guňková²

¹ Onkogynekologické centrum, Gynekologicko-porodnická klinika Fakultní nemocnice Ostrava

² Chirurgická klinika Fakultní nemocnice Ostrava, Lékařská fakulta Ostravské univerzity v Ostravě

Anovaginal and rectovaginal fistulas are among the most serious complications of rectal resection that occur in 0.9–10% with

a case fatality rate of 6–22 %. Subsequent reoperations can increase the rate of local recurrence and reduce the overall survival

of patients. Fistulas can be classified based on the time of origin, site of origin, and relation to the staple line. Anastomotic sepsis

and infected perianastomotic collection, usually due to anastomotic dehiscence, are the most common causes of developing

a fistula. The risk factors for developing fistulas include anastomoses within 4–7 cm, total mesorectal excision, chemoradiotherapy,

intraoperative complications associated with blood loss, advanced stages of rectal cancer, and poorly differentiated or mucinous

adenocarcinoma. The treatment of a rectovaginal fistula is challenging, frequently requiring repeated surgical interventions increasing

the morbidity of patients and delaying or precluding adjuvant therapy with an impact on the oncological outcome. For

these reasons, maximum prevention of this complication is particularly important. If this complication does occur, it is essential

to choose an optimal therapeutic approach for the particular patient, i.e. such that would least affect the patient’s morbidity and

would not reduce her chance of being cured.

Keywords: colorectal cancer, rectal resection, rectovaginal fistula

Published: May 1, 2016  Show citation