Graciloplasty for the rectovaginal fistula after chemoradiation followed by total mesorectal excision for rectal cancer

ABSTRACT

Rectovaginal fistula [RVF] is one of the intractable complications following chemoradiation and total mesorectal excision [TME] for rectal cancer. It is supposed that there is a strong possibility of this complication occurring in patients after radiation therapy and having underlying sepsis. We describe herein two female patients [73 and 40 years old] who developed RVF after chemoradiation and TME for rectal cancer, who were successfully managed by gracilis muscle transposition. Fecal diversion was done as a preliminary step to the fistula repair. Success was defined as healed fistula after stoma closure. The strategy in the present report is a useful option for RVF management in such patients as other successful modalities are very limited