학술논문
A New Technique to Repair Vesicorectal Fistula: Overlapping Rectal Muscle Plasty by Transanal Endoscopic Surgery
Document Type
Report
Author
Source
Urologia Internationalis. February 1, 2021, Vol. 105 Issue 3-4, p309, 7 p.
Subject
Language
English
ISSN
0042-1138
Abstract
Author(s): Eiji Kanehira (corresponding author) [a]; Takashi Tanida [a]; Aya Kamei Kanehira [a]; Kodai Takahashi [a]; Yuichi Obana [a]; Mistuharu Iwasaki [b]; Koji Sagawa [b] Introduction Vesicorectal fistula (VRF) as [...]
Objective: To evaluate clinical results of a novel surgical technique, we developed to repair vesicorectal fistula (VRF) occurring after prostatectomy, hospital records of the patients, who underwent the new surgical treatment, were assessed. Methods: The novel surgical technique is called "overlapping rectal muscle plasty," which is performed under transanal endoscopic microsurgery (TEM). During the new procedure, a complete fistulectomy was first performed, and then the proper muscle layer of the rectum was folded, overlapped, and sutured to create a thick wall between the rectum and urinary bladder. This operation was carried out in 15 patients with VRF following radical prostatectomy. Results: The operation was safely performed in all patients with an average time of 127.2 min. Fistula was corrected in 13 patients (86.7%), who were then freed from both urinary and intestinal diversions. Conclusions: Overlapping rectal muscle plasty by TEM is a safe procedure. The success rate seems to be acceptable in selected patients. This new repair method may be considered as a minimally invasive option in the surgical treatment of VRF after prostatectomy. Keywords: Vesicorectal fistula, Rectovesical fistula, Surgical treatment, Transanal endoscopic microsurgery
Objective: To evaluate clinical results of a novel surgical technique, we developed to repair vesicorectal fistula (VRF) occurring after prostatectomy, hospital records of the patients, who underwent the new surgical treatment, were assessed. Methods: The novel surgical technique is called "overlapping rectal muscle plasty," which is performed under transanal endoscopic microsurgery (TEM). During the new procedure, a complete fistulectomy was first performed, and then the proper muscle layer of the rectum was folded, overlapped, and sutured to create a thick wall between the rectum and urinary bladder. This operation was carried out in 15 patients with VRF following radical prostatectomy. Results: The operation was safely performed in all patients with an average time of 127.2 min. Fistula was corrected in 13 patients (86.7%), who were then freed from both urinary and intestinal diversions. Conclusions: Overlapping rectal muscle plasty by TEM is a safe procedure. The success rate seems to be acceptable in selected patients. This new repair method may be considered as a minimally invasive option in the surgical treatment of VRF after prostatectomy. Keywords: Vesicorectal fistula, Rectovesical fistula, Surgical treatment, Transanal endoscopic microsurgery