{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:34:19Z","timestamp":1789166059048,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Ano\u2010rectovaginal fistulas (ARVF) are challenging for the surgeon. Most of the series mix aetiologies, leading to confusion with respect to the conclusion. The aim of this study was to assess the factors associated with the success of ARVF management following obstetrical anal sphincter injury (OASIS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective multicentric study included all the patients undergoing surgery for ARVF identified by the hospital codes. Patients for whom the aetiology of ARVF was not OASIS were excluded. The major outcome measure was the success of the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients with treated ARVF due to OASIS were identified. The success of overall management was 91.7%. Female patients underwent a mean of 2.5 (\u00b11.7) procedures. A diverting stoma was formed in 29 patients (48.3%) of which 26 were closed at the end of the management period (89.7%). Of the 148 surgical procedures, only 55 were successful (37.2%). The order of the procedures (OR\u00a0=\u00a01.38; 95% CI: 0.75\u20132.51) or the diverting stoma (OR\u00a0=\u00a01.46; 95% CI: 0.31\u20136.91) were not significantly associated with the success of the surgery. However, Martius flap (OR\u00a0=\u00a04.13; 95% CI: 1.1\u201315.54) and Musset procedures (OR\u00a0=\u00a05.79; 95% CI: 1.77\u201318.87) produced better results than the endorectal advancement flap (ERAF). The other procedures did not show a significant correlation with management success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A diverting stoma is not mandatory in the management of ARVF due to OASIS to improve the success of the surgical procedure. While the Martius flap procedure offers better results, the ERAF procedure may be preferred as a primary intervention in the absence of sphincter injury as it is less invasive. In cases of residual sphincter injury, the Musset procedure is most likely to be the best option.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16211","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T09:23:14Z","timestamp":1654248194000},"page":"1371-1378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ano\u2010rectovaginal fistula after obstetrical anal sphincter injury: Diverting stoma does not improve the surgical results"],"prefix":"10.1111","volume":"24","author":[{"given":"Aur\u00e9lien","family":"Venara","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Angers  Angers Cedex 9 France"},{"name":"CHU Angers University of Angers  Angers France"},{"name":"CHU Angers HIFIH, SFR ICAT University of Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2403-462X","authenticated-orcid":false,"given":"Bertrand","family":"Trilling","sequence":"additional","affiliation":[{"name":"TIMC\u2010IMAG Laboratory, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital Grenoble Alps University  Grenoble France"},{"name":"Colorectal Surgery Unit, Visceral surgery and Acute Care surgery Department Grenoble Alps University Hospital  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Ngoma","sequence":"additional","affiliation":[{"name":"Institut L\u00e9opold Bellan, Groupe Hospitalier Paris Saint\u2010Joseph Service de Proctologie M\u00e9dico\u2010Chirurgicale  Paris 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Pontchaillou  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Luc","family":"Faucheron","sequence":"additional","affiliation":[{"name":"TIMC\u2010IMAG Laboratory, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital Grenoble Alps University  Grenoble France"},{"name":"Colorectal Surgery Unit, Visceral surgery and Acute Care surgery Department Grenoble Alps University Hospital  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"de Parades","sequence":"additional","affiliation":[{"name":"Institut L\u00e9opold Bellan, Groupe Hospitalier Paris Saint\u2010Joseph Service de Proctologie M\u00e9dico\u2010Chirurgicale  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Caen  Caen Cedex 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