直肠阴道瘘的病因分析和临床对策

Pathogenic analysis and clinical strategy for rectovaginal fistula

目的 探讨直肠阴道瘘的形成原因和临床对策。方法 回顾分析我院 1993～ 2 0 0 3年直肠阴道瘘患者 2 1例临床资料。结果 先天性直肠阴道瘘 12例行肛门成行术 ,患者均获痊愈 ,后天性直肠阴道瘘 9例采用不同修补式治疗 ,除复发 2例经再次手术治愈外 ,其余瘘均一期愈合。随访 1～ 9年 ,无复发。结论 直肠阴道瘘形成原因复杂 ,选择恰当的术式和手术时机、充分的术前准备以及加强术后管理是手术成败的关键。

ObjectiveTo investigate the cause and clinical strategy of rectovaginal fistula.MethodsThe clinical data of 21 patients with rectovaginal fistula were reviewed retrospectively from 1993 to 2003. The causes and the ways of treatment were summarized.ResultsTwelve patients with congenial rectovaginal fistula were treated with anoplasty,and all of the cases were cured by one-step surgery. Different fistula repairs were performed for the other 9 patients with secondary rectovaginal fistula,and 2 recurrent patients underwent novel surgical repair successfully. All patients were followed up for 1 to 9 years. During the period of follow-up,none of cases recurred.ConclusionThe cause of rectovaginal fistula was very complex. The procedures,timing of operation,preparation before operation and treatment after operation are important factors for successful surgery.