Surgical repair of complex rectovaginal fistulas: Report of two cases

摘要: Abstract A rectovaginal fistula (RVF) is an abnormal communication between the rectum and vagina. In girls, main etiologies are iatrogenic (correction of anorrectal malformations Hirschsprung disease) traumatic (sexual abuse foreign bodies). Multiple surgical approaches have been described for treatment this pathology, having posterior sagital approach, in pediatric population, one with best results. However complex RVF (epithelialized long length communications, located at upper third septum, diameters > 2.5 cm, recurrent those secondary to pelvic radiation) poor results when treated conventional techniques; they require removal peripheral fibrous tissue replacement by healthy adequate arterial supply, preserving anal canal and, consequence, fecal continence. This work describes our experience repair two patients fistulas using a combination colorectal techniques: approach transanal pull-trough (Swenson technique) complete resolution fistulas, allowing stomas closure keeping