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CASE REPORT article

Front. Gastroenterol.
Sec. Endoscopy
Volume 3 - 2024 | doi: 10.3389/fgstr.2024.1364379
This article is part of the Research Topic Case Reports in Frontiers in Gastroenterology View all 8 articles

Surgical repair of rectovaginal fistula by combined transanal and transvaginal endoscopy ：A case report

Provisionally accepted
Tian He Tian He 1*Wen Zhang Wen Zhang 1nianfen Mao nianfen Mao 2Xuan Bai Xuan Bai 1*Lin Zhao Lin Zhao 1*Ke-Lin Yue Ke-Lin Yue 1GuoQing Yang GuoQing Yang 3*Chunmei Rao Chunmei Rao 3Jing Wang Jing Wang 2*Ping Wan Ping Wan 1*Qiang Guo Qiang Guo 1*Zan Zuo Zan Zuo 1*
  • 1 The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
  • 2 Kunming University of Science and Technology, Kunming, China
  • 3 Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan Province, China

The final, formatted version of the article will be published soon.

    The common causes of rectovaginal fistula include obstetric trauma, local infection, and rectal surgery, while rectovaginal fistula following hemorrhoid surgery is extremely rare. Rectovaginal fistulae (RVF) rarely heal without intervention. Surgical treatment is usually performed, but the optimal surgical method remains controversial. The patient was a 37-year-old woman, who was transferred to our hospital due to an unsuccessful repair of a rectovaginal fistula after hemorrhoid surgery in a local hospital. The next day after admission, she was received prophylactic ileostomy, defecation diversion, and combined treatment with cephalosporin antibiotic to creat a clean postoperation area. However, there was still fecal outflow from the vagina, with no significant reduction in excretion compared to previous surgery. Digestive endoscopy confirmed a failure of the repair for rectovaginal fistula. Therefore, the preventive ileostomy was continued to reduce the accumulation of bacteria in the fistula and control the inflammation. After 8 weeks, the endoscopic fistula inflammation disappeared, and the condition of endoscopic surgery was considered to be mature. Subsequently, a new surgical method combining transanal endoscopy and transvaginal endoscopy was performed. After 12 weeks of surgery, a follow-up endoscopic examination showed that the fistula had been repaired and healed. During the 1-year follow-up, no serious complication was encountered, no recurrence was found, and the repair effect was satisfactory. In conclusion, A new technique combining transanal endoscopy and transvaginal endoscopy can effectively be used for the surgical repair of rectovaginal fistula after a hemorrhoid operation.

    Keywords: Rectovaginal fistula (RVF), Transanal endoscopic surgery (TES), transvaginal endoscopic surgery, case report, new technology

    Received: 02 Jan 2024; Accepted: 05 Apr 2024.

    Copyright: © 2024 He, Zhang, Mao, Bai, Zhao, Yue, Yang, Rao, Wang, Wan, Guo and Zuo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tian He, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
    Xuan Bai, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
    Lin Zhao, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
    GuoQing Yang, Yunnan University of Traditional Chinese Medicine, Kunming, 650500, Yunnan Province, China
    Jing Wang, Kunming University of Science and Technology, Kunming, China
    Ping Wan, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
    Qiang Guo, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
    Zan Zuo, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China

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