Comparative analysis of the effectiveness of traditional surgical treatment of post-radiation rectovaginal fistula and treatment using microinjection of autotransplant tissues

Teryushkova Zh. I., Vasilyev V. S., Vazhenin A. V., Vasilyev S. A., Lomakin E. A., Dimov G. P.

Objectives. To conduct a comparative analysis of the effectiveness of traditional surgical treatment of postradiation rectovaginal fistula and treatment using microinjection autologous tissue transplantation. Methods. The study involved 24 patients aged 54 ± 10 years with a diagnosis of postradiation rectovaginal fistula. As a medical method, the method of microinjection autotransplantation of adipose tissue was used. The efficacy analysis (case description) included data for all patients who underwent the procedure for administering autologous regenerative adipose tissue cells. In the form of lists (tables) for each patient, demographic data (age, gender) were presented, as well as the results of special examinations at the corresponding visit (before the procedure, after the procedure, 1, 3, 6, 12 months after the procedure, namely: research, anoscopy, sigmoidoscopy, colonoscopy, magnetic resonance imaging of the pelvis, endorectal ultrasound. Results. The study found that when using the surgical method for the treatment of postradiation rectovaginal fistula, postoperative complications were observed in 42.1% of patients, which indicates the need to find alternative ways to treat this pathology. In particular, if before the procedure the average diameter of the fistula was 2.5 ± 0.46 cm (M ± m), then after 3 months this indicator was 1.35 ± 0.47, and after 6 months - 1.12 ± 0, 47 cm. All patients showed complete epithelization of the defect. Duration of observation - 1 year. During this period, complications and relapses did not occur.

Keywords:rectovaginal fistula, postradiation fistula, surgical method, microinjection, autologous tissue transplantation, method efficiency, tissue epithelization.