医原性直腸尿道瘻に対する修復術 : 6例の経験

Abstract

I repaired iatrogenic recto-urethral fistulas (RUF) in 6 patients. All the fistulas had developed after surgery, 5 for prostate cancer (prostatectomy) and the remaining one for pelvic solitary fibrous tumor. All of them were“simple”fistulas. I performed repair using the transperineal approach with gracilis muscle flap interposition in 4 cases, and using the transsphincteric approach (modified York-Mason method) in 2, with the cooperation of general surgeons and/or plastic surgeons. All fistulas were successfully repaired. The operation time ranged from 414 to 464 minutes for transperineal repair and 246 and 253 minutes for transsphincteric repair. The blood loss ranged from 100 to 533 ml for transperineal repair and 30 and 60 ml for transsphincteric repair. Transsphincteric approach was less invasive and may be the first choice for simple RUF repair.