Gracilis transposition for repair of recurrent rectovaginal fistulas in Crohn's disease

Local surgery of recurrent ano-or rectovaginal fistulas does not have satisfying results. Over a period of two years seven patients with recurrent rectovaginal. fistulas were treated with graciloplasty. In all of cases M. Crohn was present for a mean of 15 years. All patients were diverted by a temporary protective ileostoma at the time of the graciloplasty. In six patient with graciloplasty the fistula was closed in a mean follow up time of 10 months. One recurrence of a rectovaginal fistula occurred. An additional positive effect of the graciloplasty is the reconstruction of perineum. Gracilis transposition in the treatment of recurrent rectovaginal fistulas in Crohn's disease have excellent short term results in our series. Graciloplasty is a good option to reconstruct the perineal defect additionally. A larger prospective series with longer follow up time will be required.