TY - JOUR
T1 - Modified Martius flap procedure for refractory ileal pouch-vestibular fistula
T2 - a report of three cases
AU - Araki, Toshimitsu
AU - Okita, Yoshiki
AU - Kawamura, Mikio
AU - Kondo, Satoru
AU - Toiyama, Yuji
AU - Hiro, Junichiro
AU - Yoshiyama, Shigeyuki
AU - Uchida, Keiichi
AU - Kusunoki, Masato
N1 - Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Purpose: Pouch-vaginal or vestibular fistula is an uncommon, but devastating complication that occurs in women after ileal J pouch-anal anastomosis. The management of these fistulae is challenging, and it is associated with high recurrence and pouch loss rates. This report describes the use of the modified Martius flap procedure for three patients with ulcerative colitis who developed refractory pouch-vestibular fistulae. Results: Three patients with ulcerative colitis, who underwent total colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis, developed pouch-vestibular fistulae. The fistulae originated in the pouch-anal anastomosis site in all three cases. We performed fistulectomy and transvaginal closure with sphincteroplasty followed by the modified Martius flap procedure under diversion ileostomy. No complications occurred after ileostomy closure, and the postoperative anal function was good. Conclusion: The modified Martius flap procedure is among the best options for patients with ulcerative colitis who develop refractory pouch-vestibular fistula as a complication of mucosal proctectomy.
AB - Purpose: Pouch-vaginal or vestibular fistula is an uncommon, but devastating complication that occurs in women after ileal J pouch-anal anastomosis. The management of these fistulae is challenging, and it is associated with high recurrence and pouch loss rates. This report describes the use of the modified Martius flap procedure for three patients with ulcerative colitis who developed refractory pouch-vestibular fistulae. Results: Three patients with ulcerative colitis, who underwent total colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis, developed pouch-vestibular fistulae. The fistulae originated in the pouch-anal anastomosis site in all three cases. We performed fistulectomy and transvaginal closure with sphincteroplasty followed by the modified Martius flap procedure under diversion ileostomy. No complications occurred after ileostomy closure, and the postoperative anal function was good. Conclusion: The modified Martius flap procedure is among the best options for patients with ulcerative colitis who develop refractory pouch-vestibular fistula as a complication of mucosal proctectomy.
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U2 - 10.1007/s00384-016-2746-8
DO - 10.1007/s00384-016-2746-8
M3 - Article
C2 - 28035458
AN - SCOPUS:85007417740
SN - 0179-1958
VL - 32
SP - 757
EP - 759
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 5
ER -