Successful omental flap coverage repair of a rectovaginal fistula after low anterior resection: a case report

Successful omental flap coverage repair of a rectovaginal fistula after low anterior resection: a case report

Background Rectovaginal fistula (RVF) is a troublesome and refractory complication after low anterior resection (LAR) for rectal cancer. An omental flap repair was performed for the RVF caused due to Crohn’s disease and childbirth trauma. However, there are few cases of an omental flap repair for RV...

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Bibliographic Details
Published in:Surgical case reports Vol. 9; no. 1; p. 61
Main Authors: Kuhara, Yuta, Hotei, Hiroshi, Hashimoto, Tatsunori, Seo, Shingo, Amioka, Ai, Murao, Naoki, Kuwada, Aki, Nakashima, Akira, Sakabe, Ryutaro, Tahara, Kou
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 18-04-2023
Springer Nature B.V
SpringerOpen
Subjects:
Case Report
Case reports
Colorectal cancer
Fistula
Laparoscopy
Low anterior resection
Medicine
Medicine & Public Health
Muscle flap
Omental flap
Ostomy
Rectal cancer
Rectovaginal fistula
Surgery
Vagina
Low anterior resection
Omental flap
Rectal cancer
Rectovaginal fistula
Muscle flap
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Summary:Background Rectovaginal fistula (RVF) is a troublesome and refractory complication after low anterior resection (LAR) for rectal cancer. An omental flap repair was performed for the RVF caused due to Crohn’s disease and childbirth trauma. However, there are few cases of an omental flap repair for RVF after LAR. Herein, we present a successfully repaired case of RVF by omental flap coverage after LAR for rectal cancer. Case presentation A 50-year-old female patient with advanced rectal cancer underwent laparoscopic LAR with double-stapling technique anastomosis and achieved curative resection. She complained of a stool from the vagina and was diagnosed with RVF on the postoperative day (POD) 18. Conservative therapy was ineffective. We performed laparoscopic fistula resection and direct closure of the vagina and rectum, designed the omentum that could reach the pelvis, repaired RVF by omental flap coverage, and performed transverse colostomy on POD 25. She was discharged on initial POD 48. Seven months after the initial operation, colostomy closure was administered. There was no recurrence of RVF found 1 year after the initial operation. Conclusions The patient achieved an omental flap coverage for RVF. We successfully performed the omental flap coverage repair in patients with RVF after the leakage of LAR. An omental flap may become an alternative treatment for muscle flap or an effective treatment for RVF.
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ISSN:2198-7793
2198-7793
DOI:10.1186/s40792-023-01642-7