Colovaginal anastomosis an unusual complication of stapler use in restorative procedure after Hartmann operation.docVIP

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Colovaginal anastomosis an unusual complication of stapler use in restorative procedure after Hartmann operation.doc

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Colovaginal anastomosis an unusual complication of stapler use in restorative procedure after Hartmann operation

World Journal of Surgical Oncology BioMedCentral Case report Open Access Colovaginal anastomosis: an unusual complication of stapler use in restorative procedure after Hartmann operation Zhongshu Yan* and Guoqing Liao Address: Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China Email: Zhongshu Yan* - zhongshu.yan@163.com; Guoqing Liao - liaoguoqing@ * Corresponding author Published: 15 November 2005 Received: 21 June 2005 Accepted: 15 November 2005 World Journal of Surgical Oncology 2005, 3:74 doi:10.1186/1477-7819-3-74 This article is available from: /content/3/1/74 ? 2005 Yan and Liao; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Rectovaginal fistula is uncommon after lower anterior resection for rectal cancer. The most leading cause of this complication is involvement of the posterior wall of the vagina into the staple line when firing the circular stapler. Case presentation: A 50-year-old women underwent resection for obstructed carcinoma of the sigmoid colon with Hartmann procedure. Four months later she underwent restorative surgery with circular stapler. Following which she developed rectovaginal fistula. A transvaginal repair was performed but stool passing from vagina not per rectum. Laporotomy revealed colovaginal anastomosis, which was corrected accordingly. Patient had an uneventful recovery. Conclusion: Inadvertent formation of colovaginal anastomosis associated with a rectovaginal fistula is a rare complication caused by the operators error. The present case again highlights the importance of ensuring that the posterior wall of vagina is away from the staple line. Background reported as well