{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T11:00:00Z","timestamp":1761562800416,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T00:00:00Z","timestamp":1628899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this work was to assess whether placement of a biological mesh (Permacol<jats:sup>\u00ae<\/jats:sup>) between the vaginal and rectal sutures reduces the rate of rectovaginal fistula in patients with deep rectovaginal endometriosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We report a retrospective, comparative study enrolling patients with vaginal infiltration of more than 3\u00a0cm in diameter and rectal involvement in two centres. They benefited from complete excision of rectovaginal endometriotic nodules with or without a biological mesh placed between the vaginal and rectal sutures. The rate of rectovaginal fistula was compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and nine patients were enrolled: 42 patients underwent interposition of biological mesh (cases) and 167 did not (controls). Ninety\u2010two per cent of cases and 86.2% of controls had rectal infiltration more than 3\u00a0cm in diameter. Cases underwent rectal disc excision more frequently (64.3% vs. 49.1%) and had a smaller distance between the rectal staple line and the anal verge (4.4\u00a0\u00b1\u00a01.4\u00a0cm vs. 6\u00a0\u00b1\u00a02.9\u00a0cm). Rectovaginal fistulas occurred in 4 cases (9.5%) and 12 controls (7.2%). Logistic regression analyses revealed no difference in the rate of rectovaginal fistula following the use of mesh (adjusted OR 1.6, 95% CI 0.3\u20139.5). A distance of less than 7\u00a0cm between the rectal staple line and the anal verge was found to be an independent risk factor for the development of rectovaginal fistula (adjusted OR 15.1, 95% CI 1.7\u2013132).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that the placement of a biological mesh between the vagina and rectal sutures may not affect the rate of formation of postoperative rectovaginal fistula following excision of deep infiltrating rectovaginal endometriosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15855","type":"journal-article","created":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T17:30:26Z","timestamp":1628443826000},"page":"2731-2740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Interposition of a biological mesh may not affect the rate of rectovaginal fistula after excision of large rectovaginal endometriotic nodules: a pilot study of 209 patients"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-0628","authenticated-orcid":false,"given":"Horace","family":"Roman","sequence":"first","affiliation":[{"name":"IFEMEndo Clinique Tivoli\u2010Ducos Bordeaux France"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Pontr\u00e9","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Perth WA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Braund","sequence":"additional","affiliation":[{"name":"Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitham","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Surgery Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemence","family":"Klapczynski","sequence":"additional","affiliation":[{"name":"Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clotilde","family":"Hennetier","sequence":"additional","affiliation":[{"name":"Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rie","family":"Bridoux","sequence":"additional","affiliation":[{"name":"Department of Surgery Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Jacques","family":"Tuech","sequence":"additional","affiliation":[{"name":"Department of Surgery Rouen University Hospital Rouen France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2013.12.094"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.09.006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq057"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmv003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa131"},{"volume-title":"StatPearls","year":"2019","author":"Tuma F","key":"e_1_2_10_7_1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199802000-00005"},{"key":"e_1_2_10_9_1","first-page":"1694","article-title":"The value of omentoplasty in protecting colorectal anastomosis from leakage. 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