Abscess

Reports summarize surgery study results from O. Schwandner and co-researchers

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"All patients with a rectovaginal fistula who underwent definitive surgery using Surgisis mesh were prospectively enrolled in this study. Inclusion criteria included a rectovaginal fistula in the lower two-thirds of the rectovaginal septum. Surgery was performed with a standardized technique including combined transrectal and transvaginal excision of the rectovaginal fistula with transvaginal placement of the mesh. Success was defined as closure of both internal and external (perianal and vaginal) openings, absence of drainage without further intervention, and no abscess formation. Over a period of 16 months, a total of 21 mesh procedures were performed in two centres. The mean age of the patients was 47 years (18-59 years). Of the 21 patients, 18 (86%) had recurrent rectovaginal fistula, and the mean number of prior attempts was 2.3 (0-8). The majority of patients (nine) had Crohn's disease-associated fistula, followed by six with iatrogenic fistula, two with radiation-induced fistula, two with obstetric injuryinduced fistula, and two with idiopathic fistula. The mesh procedure was performed under faecal diversion in eight patients (38%). The mean operative time was 38 min; no intraoperative morbidity occurred. were discharged from hospital on day 4. After a mean follow-up of 12 months (range, 3-18 months), the overall success rate after primary mesh procedure was 71% (15/21; 6 patients had failure or recurrence). All patients with failure or recurrence were reoperated upon. Out of these six patients who were reoperated upon, four had definite healing (75%). Among the eight patients who had faecal diversion, four (50%) had reversal of their stoma. The preliminary success rate for this innovative technique using Surgisis mesh for the closure of rectovaginal fistulas is promising," wrote O. Schwandner and colleagues.

The researchers concluded: "Further studies are needed to assess the definite role of this novel technique in comparison to traditional surgical procedures.."

Schwandner and colleagues published their study in Techniques in Coloproctology (Innovative technique for the closure of rectovaginal fistula using Surgisis™ mesh. Techniques in Coloproctology, 2009;13(2):135-140).

For additional information, contact O. Schwandner, Caritas Krankenhaus St. Josef, Dept. of Surgery, Landshuter Str 65, D-93053 Regensburg, Germany.

Publisher contact information for the journal Techniques in Coloproctology is: Springer, 233 Spring St., New York, NY 10013, USA.

Keywords: Germany, Regensburg, Abscess, Bioprosthesis, Biotechnology, Crohn Disease, Gastroenterology, Gastrointestinal, Surgery.

This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.