直肠阴道瘘的临床治疗策略  

Treatment strategies for rectovaginal fistula

作　　者：李阿建 薛利军 张亚杰[1] 彭健[3] 张勇[3] 唐文贤[3] 吕亮[3] 林谋斌[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025 [2]上海大场医院普外科,上海200436 [3]同济大学医学院附属杨浦医院普外科,上海200090

出　　处：《外科理论与实践》2014年第6期514-516,共3页Journal of Surgery Concepts & Practice

基　　金：国家自然科学基金(81272480);上海市科学技术委员会资助项目(11DZ1910200;11nm0503800)

摘　　要：目的：总结直肠阴道瘘的手术治疗经验，探讨直肠阴道瘘合理的临床治疗对策。方法：回顾性分析上海交通大学医学院附属瑞金医院外科2005年2月至2014年8月之间收治的45例直肠阴道瘘的治疗情况。结果：45例病人全部采用手术治疗．其中41例治愈，随访0．5-10．0年未有复发，余4例因癌症晚期死亡。结论：根据直肠阴道瘘的瘘管情况选取最佳手术方式和时机是手术成功的关键。对处于急性期的直肠阴道瘘病人，应采用非手术治疗至少3个月后再行手术。对复发性直肠阴道瘘采用带血管蒂的全层肠片以及直肠推进瓣技术可明显提高手术成功率。Objective To study the treatment strategy for rectovaginal fistula to improve therapeutic effect. Methods The clinical data of 45 patients with rectovaginal fistula in Department of Surgery Ruijin Hospital were reviewed retrospec- tively from February 2005 to August 2014. Results All 45 patients were treated the operation. Forty-one patients were cured without recurrence during the postoperative follow-up between 0.5-10.0 years. The other 4 patients died due to the terminal stage of cancer. Conclusions The procedure and timing of operation selected according to the basis of fistula are important for successful repair. Non-operative therapy should be given for the patients with rectovaginal fistula in acute stage and the operation delays until 3 months at least. Both the endorectal advancement flap and patch of intestine provide effective methods in repairing recurrent rectovaginal fistula.

关 键 词：直肠阴道瘘 手术 直肠推进瓣 

分 类 号：R735.37[医药卫生—肿瘤]