Sigmoid colon pull-through procedure for rectovaginal fistula.

Abstract

Rectovaginal fistula following a combined radiological-surgical attack upon carcinoma of the endometrium or following radium therapy of the cervix is a complication of infrequent occurrence,1but of considerable significance. This complication is particularly unfortunate when the patient is cured of the carcinoma. It is generally agreed that rectovaginal fistulas are rare following treatment for carcinoma of the corpus. A technical error in irradiation or a posthysterectomy pelvic abscess is the most frequent cause of fistula following the treatment for carcinoma of the corpus. Rectovaginal fistula is a more frequent complication following treatment for carcinoma of the cervix, due to neoplastic invasion of the rectovaginal septum. Many procedures have been described for the surgical treatment of this complication.2,3All of these procedures depend upon mobilization of intensely irradiated tissues which are fibrotic and extremely hard to dissect, in addition to which there is poor healing. Recurrences following surgical intervention