title: Transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery: report of four cases.
abstract: OBJECTIVE
  To investigate the feasibility and superiority of transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery.
  
  
  METHODS
  The clinical data of four cases of rectovaginal fistula following rectal cancer surgery were retrospectively analyzed in our center. After adequate preoperative preparation, the patients underwent transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube under continuous epidural anesthesia. After surgery and before discharge, anti-infection and nutritional support was administered for 2 d, and fluid diet and anal tube vacuum aspiration continued for 7 d.
  
  
  RESULTS
  All the four cases healed. Three of them healed after one operation, and the other patient had obvious shrinkage of the fistular orifice after the first operation and underwent the same operation for a second time before complete healing. The duration of postoperative follow-up was 2, 7, 8 and 9 months respectively. No recurrence or abnormal sex life was reported.
  
  
  CONCLUSIONS
  Early transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube are feasible for rectovaginal fistula following rectal cancer surgery. This operation has many advantages, such as minimal invasiveness, short durations of operation, short treatment cycles, and easy acceptance by the patient. In addition, it does not necessitate colostomy for feces shunt and a secondary colostomy and reduction.
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Guo-De
authors.initials: GD
authors.lastname: Luo
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Yong-Kuan
authors.initials: YK
authors.lastname: Cao
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Yong-Hua
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Guo-Hu
authors.initials: GH
authors.lastname: Zhang
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Pei-Hong
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Center of General Surgery, The General Hospital of Chengdu Command Chengdu 610083, Sichuan Province, China.
authors.forename: Jia-Qing
authors.initials: JQ
authors.lastname: Gong
keywords: Fistula; after rectal cancer surgery; anal tube; continuous vacuum aspiration; debridement and repair; rectovaginal fistula