-Case Reports-

Early Laparoscopic Colostomy in Advanced Cancer Patients with Rectovaginal Fistula: Results of Seven Patients

Satoshi Akita^1,*, Kei Ishimaru¹, Mitsunori Sato^2,*, Katsuya Watanabe², Hiroki Sugishita², Yusuke Ogi², Jun Kuwabara², Kazufumi Tanigawa², Satoshi Kikuchi², Hironori Matsumoto², Motohira Yoshida², Shigehiro Koga² and Taro Oshikiri²

¹Department of Minimally Invasive Gastroenterology, Ehime University Graduate School of Medicine, Ehime, Japan
²Department of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine, Ehime, Japan
^*Contributed equally

A rectovaginal fistula (RVF) is an abnormal tract between the rectum and vagina, which requires surgical intervention in many cases. Although there are many different therapeutic approaches for RVF depending on the patients' condition, there are no established guidelines for the care of RVF. This study aimed to evaluate the results of laparoscopic colostomy in advanced cancer patients with RVF, and the safety and efficacy of this surgery. In this study, seven female advanced cancer patients with RVF were hospitalized and successfully treated with laparoscopic colostomy from 2015 to 2018 at our university hospital. Their data were retrospectively evaluated from their medical records. The early use of diverting stomas facilitated timely resumption of cancer treatment and enabled early treatment with chemotherapy or radiotherapy. Although vaginal stool leakage affected three patients, all patients recovered, experiencing neither pain nor infection during their cancer treatment. While colostomy was physically and mentally taxing for the patients, it improved the infection and pain caused by the RVF. We conclude that the early use of diverting stomas had two effects: a significant improvement in infection management and facilitation of the rapid resumption of cancer treatment.

J Nippon Med Sch 2025; 92: 414-419

Keywords
rectovaginal fistula, laparoscopic early colostomy, advanced cancer

Correspondence to
Mitsunori Sato, Department of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 790-0295, Japan
mit-sato@m.ehime-u.ac.jp

Received, September 29, 2023
Accepted, June 17, 2024