会陰横切開・肛門挙筋間置法による直腸膣瘻修復術

概要

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Rectovaginal fistulas occur most commonly as a result of obstetric trauma and are associated with thinning of the perineum. Simple excision of the fistula may result in improper healing, and postoperative infection may result in recurrence of the disorder. For successful repair of the disorder we introduce our procedures which include a transverse transperineal approach, wide mobilization of tissues around the fistula, excision of the entire fistula tract, closure of the vaginal and rectal orifices of the fistula, and most essentially, approximation and interposition of levator ani muscles between the vagina and the rectum. This interposition provides an additional layer of tissue, may support additional vascularization, and reinforces the closure of the fistula.
社団法人日本産科婦人科学会の論文
2000-07-01