Pedicled pudendal thigh flap for repair of rectovaginal fistula
10.3760/cma.j.cn114453-20200716-00431
- VernacularTitle:阴股沟组织瓣带蒂转移治疗直肠阴道瘘的临床应用
- Author:
Ye YUAN
1
;
Qiang LI
;
Senkai LI
;
Fengyong LI
;
Yu ZHOU
;
Yujiao CAO
;
Meichen LIU
;
Shuai QIANG
;
Kexin CHE
;
Zhen ZHANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院妇科整形中心 100144
- Keywords:
Rectovaginal fistula;
Surgical flaps;
Fascia;
Reconstructive surgical procedures
- From:
Chinese Journal of Plastic Surgery
2021;37(12):1339-1344
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the surgical methods and effects of different types of pudendal thigh flaps in repairing rectovaginal fistula.Methods:From March 1996 to November 2019, totally 18 cases with rectovaginal fistula admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The ages of the patients ranged from 17 months to 39 years with an average of 20.8 years. The bilateral pudendal thigh flap based on the anterior cutaneous branches of obturator artery can be used for larger fistula, which is larger than 1 cm in diameter and covered with serious local scars. Smaller fistula with diameter less than 1 cm can be repaired by the unilateral pudendal thigh flap pedicled with lateral branches of posterior labial artery transferred through subcutaneous tunnel. If the local tissue can be closed directly without tension, pudendal thigh fascial flap is inserted between the vaginal and rectal mucosa to act as a waterproof layer.Results:All flaps used in the 18 patients of this group survived postoperatively with fistula closure and donor site healed primarily. The size of the flaps ranged from 4 cm×2 cm to 7 cm×4 cm. The recipient sites including bilateral pudendal thigh island flaps (4 cases), unilateral pudendal thigh flaps (5 cases) and unilateral facial flaps (9 cases). No recurrence was reported during the follow-up period of 6 to 36 months.Conclusions:The application of pudendal thigh flaps can be considered as a safe and reliable procedure for the management of the middle and lower rectovaginal fistula. According to the anatomical characteristics of fistula, we could design rational flaps to meet the functional, morphological and cosmetic demands from the patients.
