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Therapeutic options in radiation-induced rectovaginal fistula

Patrycja Wręczycka-Cegielny1,2, Tomasz Cegielny2,3, Roman M. Herman4,5, Marcin Opławski1, Zbigniew Kojs6

Affiliacja i adres do korespondencji
Curr Gynecol Oncol 2016, 14 (2), p. 121–132
DOI: 10.15557/CGO.2016.0015
Streszczenie

A pathological communication between the rectum and the vagina, referred to as rectovaginal fistula, can develop as a result of a number of factors. Fistula caused by ionizing energy treatment, which belongs to the most serious late radiation-induced complications, is a special type of this abnormality. This type of fistulas are classified as complex fistulas. Their surgical treatment is very difficult and shows poor efficacy as well as high rate of recurrence. Therefore, it is still a serious and current problem of women after radiation therapy for gynecologic cancer. The quality of life in patients with this complication is dramatically poor. Despite completed cancer treatment, women with radiation-induced rectovaginal fistula are often unable to resume their previous social roles, including work. Therefore, it is important to determine the optimal management strategy in these patients. Although it may seem impossible to develop a simple diagnostic and therapeutic algorithm due to different fistula locations and sizes, the knowledge on the basic management strategies increases the chance of success. A surgery using the transabdominal approach described by Parks is the primary surgical technique. However, new reports on repair techniques, particularly less invasive ones, occasionally occur in literature. Therefore, we present a current literature review of treatment options in radiation-induced rectovaginal fistulas.

Słowa kluczowe
rectovaginal fistula, radiation-induced fistula, radiation-induced complications