title: Endoscopic placement of self-expandable metallic stents for rectovaginal fistula after colorectal resection: a comparison with proximal diverting ileostomy alone.
abstract: BACKGROUND
  Self-expandable metal stents can be used to treat patients with rectovaginal fistula after colorectal resection for cancer.
  
  
  METHODS
  Fifteen patients with rectovaginal fistula, after colorectal resection for cancer, were treated with endoscopic placement of a self-expandable metal stent. In four patients, a diverting proximal stoma had been performed elsewhere. Mean age was 58 years. All patients had preoperative radiotherapy. In ten patients, the stent was placed as initial form of treatment. Four patients were referred after multiple failed operations. The control group consisted of ten patients who had rectovaginal fistula and underwent proximal diverting ileostomy and percutaneous drainage of the surrounding abscess
  
  
  RESULTS
  One patient was not able to tolerate the stent, which was removed. At a mean follow-up of 22 months, the rectovaginal fistula healed in 12 patients. In the remaining two patients, the fistula has reduced significantly in size to allow a successful flap transposition. The fistula healed only in five out of the ten patients who had only a proximal ileostomy.
  
  
  CONCLUSIONS
  Endoscopic placement of self-expandable metal stents represents a valid adjunctive to treat patients with rectovaginal fistula, after colorectal resection for cancer.
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Lamazza
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Fiori
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy. antonio.sterpetti@uniroma1.it.
authors.forename: Antonio V
authors.initials: AV
authors.lastname: Sterpetti
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Schillaci
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Cesare
authors.affiliation: Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico, 00167, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Lezoche
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D012006:Rectovaginal Fistula / Q000601:surgery*; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents
keywords: Cancer; Colorectal; Instruments; Technical