Postirradiation rectovaginal fistula repaired with the aid of platelet-rich plasma (autologous platelet gel)
Autori: M. Mongardini – R.P. Iachetta – A. Cola – G. Ferrazza – E. Degli Effetti – F. Custureri - GENNAIO 2007
Università degli Studi di Roma "La Sapienza" – Dipartimento di Scienze Chirurgiche – Azienda Policlinico Umberto I – ROMA
- 3°Congresso Nazionale SIUCP e 2° World Congress of Coloproctology and Pelvic Diseases, Innovation and Current Debates – Roma, 18-20 giugno 2007;
- XVIII Congresso di Chirurgia dell’Apparato Digerente – Roma, 27-18 settembre 2007;
- 109° Congresso SIC – Verona, 14-17 ottobre 2007
A 65-year-old severely obese woman presented with a low rectovaginal fistula about 2 cm in diameter that developed after adjuvant irradiation for a uterine carcinoma (two endovaginal brachytherapy sessions each at a dose of 60 Gy). The patient underwent transverse colostomy and 10 days later fistulectomy. The posterior vaginal wall was transvaginally excised to expose the rectal wall and the fistula. The periorificial tissue was then transanally resected full-thickness using a circular stapler (PPH0133). The rectal suture was transvaginally reinforced with muscle stitches, the mouth mucosal-submucosal flap was interposed, fixed and three layers of autologous platelet gel were applied. The vaginal peri-orificial tissues were then resected and the posterior vaginal wall was sutured.