title: Treatment of rectovaginal fistula by magnetic compression.
abstract: OBJECTIVE
  Rectovaginal fistula (RVF) is an abnormal epithelium-lined connection between the rectum and vagina. The primary effective treatment is surgical repair, but recurrence remains a challenge. Magnetic compression anastomosis (MCA), an alternative to suturing, has been developed to generate an anastomosis between various hollow viscera. We hypothesized that the MCA approach could be used to treat RVF.
  
  
  METHODS
  We designed a novel MCA device for RVF treatment and evaluated the magnetic compression procedure in a RVF pig model in comparison with the traditional suturing procedure. Following satisfactory outcomes, we also applied the MCA procedure to a human patient with recurrent RVF. The MCA device was designed based on the anatomical characteristics of the pig vagina and previous literature. The pig RVF model were established surgically (n = 12), and compression and control groups were each treated. The data were analyzed by one-way analysis of variance.
  
  
  RESULTS
  qqExcept in one animal in each group, the RVF site was smooth and healing was complete. Histological analysis confirmed complete healing of the RVF with high histological continuity to neighboring tissues. The compression procedure applied to our patient with RVF was successful. The patient recovered quickly without complications, and RVF did not recur during a 15-month follow-up.
  
  
  CONCLUSIONS
  From this preliminary investigation, MCA using our novel device appears to be a safe, simple, and effective nonsurgical procedure for the treatment of RVF.
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.|Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia, 017000, China.
authors.forename: Zhan-Fei
authors.initials: ZF
authors.lastname: She
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Xiao-Peng
authors.initials: XP
authors.lastname: Yan
authors.affiliation: XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Ma
authors.affiliation: XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Hao-Hua
authors.initials: HH
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Yang
authors.affiliation: XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Shi
authors.affiliation: Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia, 017000, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia, 017000, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Qi
authors.affiliation: Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia, 017000, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xiao
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China.
authors.forename: Yu-Liang
authors.initials: YL
authors.lastname: Zou
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com.|XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com.|Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000704:Analysis of Variance; D000818:Animals; D016022:Case-Control Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D059346:Magnets; D023421:Models, Animal; D012006:Rectovaginal Fistula / Q000628:therapy*; D012008:Recurrence; D000071062:Sutureless Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D013537:Sutures / Q000009:adverse effects; D013552:Swine; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery; D014945:Wound Healing
keywords: Magnetic compression anastomosis; Pig model; Rectovaginal fistula; Surgery