Biomaterial Database

Redo gracilis interposition for complex perineal fistulas. 2020

H Gilshtein, and V Strassman, and S D Wexner

Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.

Rectovaginal, pouch-vaginal, and recto-urethral fistulas are very challenging to treat. Gracilis muscle interposition was shown be an effective treatment for these complex fistulas. The aim of this study was to investigate the feasibility and outcomes of redo gracilis interposition for persistent and recurrent complex perineal fistulas. A retrospective analysis of all patients who had redo gracilis muscle interposition for complex perineal fistulas at our institution from 1995 to 2019 was performed. Nine patients (5 males, mean age 55 years) were included for analysis. The types of fistulas were recto-urethral (n = 5), rectovaginal (n = 2) and pouch-vaginal (n = 2). The success rate was 56% with 5 patients achieving complete healing of the fistula. Only 1 patient (11%) experienced a postoperative complication. Redo gracilis muscle interposition is feasible and safe with promising resultsin healing of complex perineal fistula.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D012003	Rectal Fistula	An abnormal anatomical passage connecting the RECTUM to the outside, with an orifice at the site of drainage.	Anal Fistula,Fistula, Rectal
D012006	Rectovaginal Fistula	An abnormal anatomical passage between the RECTUM and the VAGINA.	Fistula, Rectovaginal,Fistulas, Rectovaginal,Rectovaginal Fistulas
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071976	Gracilis Muscle	A slender and most superficial muscle in the inner THIGH which originates at the ramus of the PUBIC BONE near the PUBIC SYMPHYSIS and inserts at the proximal medial TIBIA. Its function is to abduct thigh, flex knee, and rotate leg medially. It is a common source of a MYOCUTANEOUS FLAP.	Gracilis Muscles,Muscle, Gracilis,Muscles, Gracilis
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D013524	Surgical Flaps	Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region.	Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D014548	Urinary Fistula	An abnormal passage in any part of the URINARY TRACT between itself or with other organs.	Fistula, Urinary,Fistulas, Urinary,Urinary Fistulas