Surgical repair of complex rectovaginal fistulas - JPS July
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A rectovaginal fistula (RVF) is an abnormal communication between the rectum and the vagina. In girls, the main etiologies are iatrogenic (correction of anorrectal malformations and Hirschsprung disease) and traumatic (sexual abuse and foreign bodies).Multiple surgical approaches have been described for the treatment of this pathology, having the posterior sagital approach, in pediatric population, the one with best results. However the complex RVF (epithelialized long length communications, located at the upper third of the rectovaginal septum, diameters > 2.5 cm, and recurrent and those secondary to pelvic radiation) have poor results when are treated with conventional techniques; they require the removal of peripheral fibrous tissue and replacement by healthy tissue with adequate arterial supply, preserving the anal canal and, in consequence, fecal continence....

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