title: Analysis of a Surgical Treatment for Persistent Urorectal Fistulas after Radical Cancer Surgery: A Comparison of Prostate Cancer and Rectal Cancer.
abstract: BACKGROUND
  The study aimed to present our experience of surgical treatment for urorectal fistulas (URF) that develop after cancer surgery.
  
  
  METHODS
  Fourteen patients with URF who were treated at our institution from 2005 through 2015 were retrospectively analyzed. Among these, 7 patients had previous surgical treatment of prostate cancer (PC) and the other 7 had been treated for rectal cancer (RC). The fistula was resected through a perineal incision, and the urinary and fecal defects were separately closed with the hinge flap method followed by interposition of a muscle flap transfer.
  
  
  RESULTS
  The overall fistula closure rate was 79%. Although the closure rate of the URF was lower in patients with previous RC surgery compared to the PC patients (57 vs. 100%), it did not reach statistical significance.
  
  
  CONCLUSIONS
  URF treatment using an interposition muscle flap offers a high success rate of fistula closure. However, complicated fistulas occurring after RC surgery involving the prostate or the seminal vesicle might be difficult to repair by this surgery alone.
authors.affiliation: Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Komai
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
mesh_terms: D000368:Aged; D000071976:Gracilis Muscle / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012003:Rectal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D017568:Rectus Abdominis / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects; D016896:Treatment Outcome; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
keywords: Interposition muscle flap; Prostate cancer; Rectal cancer; Urorectal fistula