Fasciocutaneous lotus petal flap in the treatment of chronic pouch-vaginal fistula in ulcerative colitis
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Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical gold standard for patients with ulcerative colitis and familial adenomatous polyposis who require proctocolectomy .
Development of a pouch-vaginal fistula (PVF) is a feared complication of this surgery. PVF appears in about 4–16% of patients who have had IPAA, and is present in 21–30% in the case of concomitant pouch failure. Early fistulae are most likely associated with technical aspects of surgery, whereas late fistulae result from a diverse range of other causes (e.g., local inflammation, chronic anastomic leakage, and radiation damage) .
A tension-free anastomosis with good blood supply is crucial for successful healing of bowel anastomoses. Initial reports noted a higher incidence of PVF with a stapled anastomosis, probably due to staple line being too close to the vaginal wall . In contrast, two randomized trials found no difference between techniques ...
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The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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