Repair of small rectovaginal fistula

Rectal vaginal fistula is a common form of fecal fistula, mostly caused by birth trauma. Surgical accidental injury or tumor erosion, radiation damage, trauma, and drug corrosion are occasionally seen. Surgery repairs the pupil. Treatment of diseases: rectal vaginal fistula Indication In addition to congenital rectal vaginal fistula in early childhood should be treated by pediatric surgery, all of the traumatic old rectal vaginal fistula can be repaired by gynecology. After clearing local inflammation, the menstruation is cleaned for about 5 days. Contraindications Systemic or local acute and chronic inflammation, diabetic patients must be treated after or after treatment. Pay attention to the existence of recessive diabetes, which must be cured or controlled before surgery. Preoperative preparation 1. Intestinal preparation: Take intestinal antibiotics 3 days before surgery. 2, clean the intestines: 1 day before the operation 2 days per day enema, 1 morning morning enema. Or the enema was cleaned 1 day before surgery, and the enema was not performed on the morning of the operation. 3, diet: 3d before surgery, no residue or less residue diet. There was no slag fluid on the day before surgery, and fasting to the next morning surgery. 4, vaginal washing and sitting bath: 2 days before surgery, wash the bath once a day, then rinse the vagina once. Surgical procedure Take the bladder lithotomy position. 1. Expose the pupil Use a vaginal pull hook to place the anterior wall of the vagina to expand the vaginal exposure field The labia minora on both sides are fixed on the disinfecting napkins on both sides. A piece of sterile gauze was inserted into the rectum to block the intestinal effluent. 2, cutting An annular incision was made outside the scar around the pupil to cut the entire layer of the vaginal mucosa and peeled to the circumference about 2 cm wide. Trim the scar around the pupil, fully free around the fistula, the front wall of the rectum 3, stitching Use a 3-0 absorbable suture or a round needle 3-0 gut to make a purse-inverted suture along the outer edge of the pupil, and turn the rectal mucosa into the intestine to close the pupil. Do not penetrate the rectal mucosa to avoid leakage after surgery. The vaginal submucosal connective tissue and the levator ani muscle were then sutured intermittently with a 2-0 absorbable suture to cover the pupil suture. The vaginal wall mucosa was sutured intermittently with a 2-0 absorbable suture. After the operation, the gauze in the rectum was removed. complication The most common complications are: 1, vaginal fistula. 2, pelvic infection, abscess formation. 3, vaginal adhesions, partial vaginal atresia. 4. Toxic shock syndrome.

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