{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:37:09Z","timestamp":1778654229732,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"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":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Rectovaginal fistulas in patients with Crohn's disease are challenging to manage, and surgical treatment remains the best option for achieving permanent closure of the fistula. Biologicals are now used routinely for patients with Crohn's disease. The aim of this study was to investigate the surgical procedures used by us to treat rectovaginal fistula in patients with Crohn's disease in the era of biologicals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients with Crohn's disease who underwent surgery for a rectovaginal fistula between 2010 and 2020 were included in this retrospective study and were identified from a prospectively maintained institutional database. Collected variables included demographics, perioperative and operative variables and data regarding medications used. Success of the procedure was defined as no symptoms at least 6\u2009months after definitive repair and\/or stoma closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients (out of 80 referred for evaluation) underwent surgery with intent to close the fistula and had at least 6\u2009months of follow\u2010up. Mean age was 44\u2009\u00b1\u200912\u2009years with a median follow\u2010up duration of 33\u2009months (range 6\u2013130\u2009months). Forty per cent of the patients had a history of at least two surgeries to close the fistula. The overall healing rate was 70% (14\/20). The most performed procedure was a transanal rectal advancement flap (7\/20), with a success rate of 85%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rectovaginal fistula in Crohn's disease is difficult to cure; according to our results almost half of these patients have multiple surgeries due to recurrence. Multiple procedures may be offered for this challenging problem in motivated patients. Perioperative diversion should be strongly considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16660","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T05:44:27Z","timestamp":1689659067000},"page":"1653-1657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["What are the outcomes in patients referred to a tertiary referral centre for Crohn's rectovaginal fistula surgery?"],"prefix":"10.1111","volume":"25","author":[{"given":"Ipek","family":"Sapci","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massarat","family":"Zutshi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio 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advancement flap repair of rectovaginal and other complicated anorectal fistulas","volume":"114","author":"Kodner IJ","year":"1993","journal-title":"Surgery."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6661"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000099"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000614"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001005"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-007-0294-y"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001004"}],"updated-by":[{"DOI":"10.1111\/codi.17195","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000}}],"container-title":["Colorectal 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