Zhan-Fei She1,2,3,4, Xiao-Peng Yan1,2,3, Feng Ma2,3, Hao-Hua Wang2,3, Huan Yang1,2,3, Ai-Hua Shi2,3, Liang Wang4, Xin Qi4, Bin Xiao4, Yu-Liang Zou5, Yi Lv6,7,8. 1. Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. 2. XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. 3. Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China. 4. Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia, 017000, China. 5. Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. 6. Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com. 7. XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com. 8. Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China. luyi169@126.com.
Abstract
INTRODUCTION AND HYPOTHESIS: Rectovaginal fistula (RVF) is an abnormal epithelium-lined connection between the rectum and vagina. The primary effective treatment is surgical repair, but recurrence remains a challenge. Magnetic compression anastomosis (MCA), an alternative to suturing, has been developed to generate an anastomosis between various hollow viscera. We hypothesized that the MCA approach could be used to treat RVF. METHOD: We designed a novel MCA device for RVF treatment and evaluated the magnetic compression procedure in a RVF pig model in comparison with the traditional suturing procedure. Following satisfactory outcomes, we also applied the MCA procedure to a human patient with recurrent RVF. The MCA device was designed based on the anatomical characteristics of the pig vagina and previous literature. The pig RVF model were established surgically (n = 12), and compression and control groups were each treated. The data were analyzed by one-way analysis of variance. RESULTS: qqExcept in one animal in each group, the RVF site was smooth and healing was complete. Histological analysis confirmed complete healing of the RVF with high histological continuity to neighboring tissues. The compression procedure applied to our patient with RVF was successful. The patient recovered quickly without complications, and RVF did not recur during a 15-month follow-up. CONCLUSIONS: From this preliminary investigation, MCA using our novel device appears to be a safe, simple, and effective nonsurgical procedure for the treatment of RVF.
INTRODUCTION AND HYPOTHESIS: Rectovaginal fistula (RVF) is an abnormal epithelium-lined connection between the rectum and vagina. The primary effective treatment is surgical repair, but recurrence remains a challenge. Magnetic compression anastomosis (MCA), an alternative to suturing, has been developed to generate an anastomosis between various hollow viscera. We hypothesized that the MCA approach could be used to treat RVF. METHOD: We designed a novel MCA device for RVF treatment and evaluated the magnetic compression procedure in a RVF pig model in comparison with the traditional suturing procedure. Following satisfactory outcomes, we also applied the MCA procedure to a humanpatient with recurrent RVF. The MCA device was designed based on the anatomical characteristics of the pig vagina and previous literature. The pig RVF model were established surgically (n = 12), and compression and control groups were each treated. The data were analyzed by one-way analysis of variance. RESULTS: qqExcept in one animal in each group, the RVF site was smooth and healing was complete. Histological analysis confirmed complete healing of the RVF with high histological continuity to neighboring tissues. The compression procedure applied to our patient with RVF was successful. The patient recovered quickly without complications, and RVF did not recur during a 15-month follow-up. CONCLUSIONS: From this preliminary investigation, MCA using our novel device appears to be a safe, simple, and effective nonsurgical procedure for the treatment of RVF.
Entities:
Keywords:
Magnetic compression anastomosis; Pig model; Rectovaginal fistula; Surgery
Authors: Ramin Jamshidi; Jacob T Stephenson; Jared G Clay; Kullada O Pichakron; Michael R Harrison Journal: J Pediatr Surg Date: 2009-01 Impact factor: 2.545