title: Does fecal diversion offer any chance for spontaneous closure of the radiation-induced rectovaginal fistula?
abstract: Analysis of the clinical course of patients with postirradiation rectovaginal fistula after fecal diversion. The studied group included 17 women with postirradiation rectovaginal fistula who underwent fecal diversion as a sole mode of treatment, between January 1987 and December 2002, in our department. All patients were subjected to radiotherapy due to cancer of the uterine cervix, administered 5-107 months before the fistula appearance (mean, 22.9 months). In 3 of 17 patients (18%), spontaneous closure of fistula was observed after 5, 6, and 9 months, respectively, from fecal diversion. Closure was confirmed by endoscopy. Length of follow-up after fecal diversion ranged from 0.5 to 122 months. The actuarial probability of spontaneous closure of postradiotherapy rectovaginal fistula was 0.24 at 9 months of follow-up and then remained stable thereafter. In conclusion, colostomy alone gives hardly a chance for closure of the postradiotherapy rectovaginal fistula. Additional surgical measures are necessary.
authors.affiliation: Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Lodz, Poland. januszpiekar@poczta.onet.pl
authors.forename: J H
authors.initials: JH
authors.lastname: Piekarski
authors.forename: B A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.forename: D
authors.initials: D
authors.lastname: Nejc
authors.forename: P
authors.initials: P
authors.lastname: Pluta
authors.forename: W
authors.initials: W
authors.lastname: Szymczak
authors.forename: P
authors.initials: P
authors.lastname: Sek
authors.forename: A
authors.initials: A
authors.lastname: Bilski
authors.forename: L
authors.initials: L
authors.lastname: Gottwald
authors.forename: A
authors.initials: A
authors.lastname: Jeziorski
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000601:surgery*; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D012006:Rectovaginal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000532:radiotherapy*