caa a22 4500 606248358 CHVBK 20210128101350.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-015-1218-7 doi (NATIONALLICENCE)springer-10.1007/s12262-015-1218-7 Complex Rectovaginal Fistula—an Experience at a Tertiary Care Centre [Elektronische Daten] [Shailendra Lalwani, Vibha Varma, Vinay Kumaran, Naimish Mehta, Samiran Nundy] Complex rectovaginal fistulae are difficult to manage. With an initial failed attempt, a simple fistula becomes complex and the success rate of a subsequent repair decreases. A review of our prospectively maintained records over a period of 16years revealed 25 patients with rectovaginal fistulae. A variety of procedures was performed in these patients according to their aetiology, site and if there had been a previous attempt at repair. The mean age of the patients was 45years. The most common cause was operative trauma in 14 cases. Ten patients had previous attempts at repair which had not been successful. The surgical procedures we performed included re-enforcement flaps, resection with diversion, repair with re-enforcement with omentum and simple diversion. Two patients developed recurrence, and one of them healed after a second repair. No recurrence developed in 10 patients who had failed attempts at repair elsewhere. Our experience has shown that most complex rectovaginal fistulae can be successfully repaired but they might require repeated operations. Faecal diversion is usually necessary, and in recurrent fistulae, we found that rather than a local repair, a muscle flap or omental interposition improves the chances of healing. Association of Surgeons of India, 2015 Rectovaginal fistula nationallicence Recurrent fistula nationallicence Pouchvaginal fistula nationallicence Gracilis flap repair nationallicence Lalwani Shailendra Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut Varma Vibha Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut Kumaran Vinay Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut Mehta Naimish Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut Nundy Samiran Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 1142-1147 0972-2068 77<1142 2015 77 12262 https://doi.org/10.1007/s12262-015-1218-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-015-1218-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lalwani Shailendra Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut NATIONALLICENCE 700 1- Varma Vibha Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut NATIONALLICENCE 700 1- Kumaran Vinay Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut NATIONALLICENCE 700 1- Mehta Naimish Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut NATIONALLICENCE 700 1- Nundy Samiran Department of Surgical Gastroenterology & Liver Transplantation, Sir Ganga Ram Hospital, Room No 2222, 110060, New Delhi, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 1142-1147 0972-2068 77<1142 2015 77 12262