The Effective Analysis Of The Conservative Treatment About Rectovaginal Fistula(RVF) After The Radical Resection Of Rectal Carcinoma

Objective: To explore the feasibility and efficacy of early conservative treatment about rectalvaginal fistula after radical resection of rectal cancer. Methods: 38 cases with rectalvaginal fistula after radical resection of rectal cancer were collected in the second people’s Hospital of Chengdu, Sichuan Provincial People’s Hospital and Chengdu Sixth People’s Hospital in January 2005 to December 2015 period. These 38 patients were in accord with the indications of conservative treatment. The data of 38 patients were analyzed retrospectively and were divided into the conservative treatment group(group A) and the enterostomy group(goup B) according to the different early treatment. Compared two groups of control of inflammation, nutritional status, liver and kidney function damage rate in early treatment process and the average total hospitalization time, the average total hospitalization expenses, complications and fistula healing situation in the whole course of disease, the difference between the both groups of clinical efficacy was explored. Results: No significant difference between the two groups of patients were observed for age, type and size of RVF, occurrence time of RVF, the level of Hemoglobin and serum albumin(P>0.05). In the course of treatment, group A was superior to group B in the control of inflammation and nutritional status. After one week treatment, WBC count in group A was lower than that in group B(P=0.000). The percent of neutrophile granulocyte in group A was lower than that in group B(P=0.001). The albumin level of group A was higher than that in group B(P=0.037). After two weeks treatment, WBC count in group A was still lower than that in group B(P=0.048). The percent of neutrophile granulocyte in group A was still lower than that in group B(P=0.012). The albumin level of group A was still higher than that in group B(P=0.017). The third weeks in the treatment, There was no significant difference in comparing the damage rate of Liver and kidney function between two groups(P>0.05). The healing rate of fistula in group A was higher than that in group B, the difference was not significant(P>0.05). The healing rate of fistula of group A in 3 months was significantly higher than group B(P=0.042). In the whole course of the disease, the complications of the group A were less than that of the group B. The average total hospitalization time in the group A were shorter than that in group B(P=0.004). The average total hospitalization costs were less than that in group B(P=0.024). Conclusion: According to the indications and contraindications, It is effective and feasible to carry out conservative treatment for the patients with rectal vaginal fistula after radical resection of rectal cancer, and most of the fistulas can be healing. Conservative treatment has the corresponding advantage in controlling inflammation, maintaining better nutritional status, reducing complications, shortening the course of the disease and reducing the cost of hospitalization.