LAPAROSCOPIC REDO ENDORECTAL PULL-THROUGH PROCEDURE FOR COMPLEX RECTOVAGINAL FISTULA AFTER RECTAL RESECTION FOR ENDOMETRIOSIS.
Sergio Eduardo Alonso Araujo, Francisco Tustumi*, Ana S. Portilho, Lucas S. Gerbasi, Rafael Vaz Pandini, Marleny N. Figueiredo, Lucas de Araujo Horcel, Marilia Marcelino, Rafaela d. Novo, Elis Oliveira, Victor Edmond Seid
Sociedade Beneficente Israelita Brasileira Albert Einstein, Sao Paulo, São Paulo, Brazil
A 36 years old woman underwent rectal resection with colpotomy for endometriosis. The patient presented an anastomotic leak and colpotomy breakdown, and a laparoscopic lavage of pelvic fecal peritonitis with a protective ileostomy was performed. Patient developed a rectovaginal fistula. We performed a pull-through procedure with delayed anastomosis associated with the repair of the vaginal defect and ileostomy closure. The coloanal anastomosis was performed 8 days after the pull-through procedure. A new rectovaginal fistula recurrence was observed, and a new redo pull-through was performed. Further resection of the colonic stump with a coloanal anastomosis after 18 days was uneventful.
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