| Title |
Gracilis transposition for repair of recurrent anovaginal and rectovaginal fistulas in Crohn’s disease
|
|---|---|
| Published in |
International Journal of Colorectal Disease, December 2007
|
| DOI | 10.1007/s00384-007-0413-9 |
| Pubmed ID | |
| Authors |
Alois Fürst, Christin Schmidbauer, Justyna Swol-Ben, Igors Iesalnieks, Oliver Schwandner, Ayman Agha |
| Abstract |
Local surgical procedures in the presence of Crohn's disease have a markedly reduced success rate, especially in the treatment of recurrent anovaginal and distant rectovaginal fistulas. In these patients, local surgery (e.g., flap closure) has unsatisfactory results if the anal canal is destroyed by ulceration and indurations or in patients with extensive defects of the perineum. Over a period of 6 years (2000 to 2006), 12 patients with recurrent rectovaginal fistulas were treated with graciloplasty. The age of the female patients ranged from 24 to 47 years, the mean age being 38 years. The presence of Crohn's disease in all patients had a mean duration of 12 years. Corticosteroids, mesalazin, or azathioprin were administered preoperatively. All patients were diverted by a temporary ileostomy before graciloplasty. RESULTS Rectovaginal fistula was closed in 11 of 12 patients after graciloplasty with a mean follow-up of 3.4 years. One rerecurrence of a rectovaginal fistula was documented. One of 12 ileostomies was not closed due to persistence of the fistula tract. One patient had a pouch-anal and, additionally, a pouch-vaginal fistula. In this patient, the first transposition of the gracilis muscle was unsuccessful. After a few months, she underwent renewed graciloplasty. There was no recurrence of a fistula within the follow-up period. Reconstruction of the perineum constituted an additional positive effect of the graciloplasty. In one patient, the preexisting fecal incontinence persisted, even after secondary implantation of a pacemaker. Due to diarrhea and persistent fecal incontinence, the patient opted for a renewed ileostomy. In our series, gracilis transposition in the treatment of recurrent anovaginal and rectovaginal fistulas in patients with Crohn's disease has excellent short-term results. In addition, graciloplasty can reconstruct the perineal defect. |
Mendeley readers
The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 2% |
| Unknown | 45 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 26% |
| Other | 9 | 20% |
| Student > Master | 4 | 9% |
| Student > Ph. D. Student | 3 | 7% |
| Student > Postgraduate | 3 | 7% |
| Other | 6 | 13% |
| Unknown | 9 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 63% |
| Nursing and Health Professions | 2 | 4% |
| Environmental Science | 1 | 2% |
| Linguistics | 1 | 2% |
| Social Sciences | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 11 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 January 2012.
All research outputs
#7,514,847
of 22,950,943 outputs
Outputs from International Journal of Colorectal Disease
#398
of 1,840 outputs
Outputs of similar age
#41,504
of 156,582 outputs
Outputs of similar age from International Journal of Colorectal Disease
#5
of 18 outputs
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