Repair of Radiation-Induced Rectovaginal Fistula With Rectal Stricture by a Combined Tuttle, Turnbull-Cutait and Singapore Flap Approach

Authors

E Barzola, Section of Colorectal Surgery, Department of Surgery, New York Medical College, Westchester Medical Center, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA. drbarzola@gmail.com.
A Kajmolli, Section of Colorectal Surgery, Department of Surgery, New York Medical College, Westchester Medical Center, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
M Gachabayov, Section of Colorectal Surgery, Department of Surgery, New York Medical College, Westchester Medical Center, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
R Bergamaschi, Section of Colorectal Surgery, Department of Surgery, New York Medical College, Westchester Medical Center, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.Follow

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1007/s13304-023-01701-6

Journal Title

Updates in Surgery

First Page

713

Last Page

717

Document Type

Article

Publication Date

4-1-2024

Department

Surgery

Abstract

Radiation-induced rectovaginal fistula (RI-RVF) with associated rectal stricture represents a challenging problem in management. The aim of the present technical note is to describe a surgical technique aimed at minimizing disease recurrence by avoiding radiated tissue in the reconstruction: 1. Tuttle longitudinal incision of posterior vaginal wall with sharp excision of proximally located fistula; 2. Resection of strictured rectum via a combined transvaginal/laparotomy access, reconstruction with Turnbull-Cutait colon pull-through, and delayed handsewn coloanal anastomosis with loop ileostomy; 3. Bridge closure of the posterior vaginal wall by the interposition of a Singapore flap. This approach resulted in a favorable outcome at the 1-year follow-up in one patient with a medical history of gynecological carcinoma status after hystero-salpingo-oophorectomy followed by adjuvant radiation.

Recommended Citation

Barzola, E., Kajmolli, A., Gachabayov, M., & Bergamaschi, R. (2024). Repair of Radiation-Induced Rectovaginal Fistula With Rectal Stricture by a Combined Tuttle, Turnbull-Cutait and Singapore Flap Approach. Updates in Surgery, 76 (2), 713-717. https://doi.org/10.1007/s13304-023-01701-6