Piekarski JH, Jereczek-Fossa BA, Nejc D, Pluta P, Szymczak W, Sek P, Bilski A, Gottwald L, Jeziorski A. Does fecal diversion offer any chance for spontaneous closure of the radiation-induced rectovaginal fistula?
Int J Gynecol Cancer 2007;
18:66-70. [PMID:
17466039 DOI:
10.1111/j.1525-1438.2007.00954.x]
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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.
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