ArticleJournal of the anus, rectum and colon2026
Vaginal Estriol Tablet Therapy for Rectovaginal Fistula after Low Rectal Surgery: Endoscopic Evaluation of Efficacy and Healing Mechanism.
Article in Journal of the anus, rectum and colon, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background and study aim: Rectovaginal fistula (RVF) remains a challenging complication after low rectal surgery, lacking a standardized, effective, and less-invasive treatment. Current strategies often require multiple invasive procedures following stoma creation. This study aimed to evaluate the outcomes and potential healing mechanisms of vaginal estriol tablet (VET) therapy for RVF following low rectal surgery. Patients and methods: A retrospective analysis was performed on the medical records and serial endoscopic images of five patients with RVF after rectal tumor surgery who received VET treatment (0.5 mg daily) between 2008 and 2024. We assessed the fistula closure rate, recurrence rate, and endoscopic findings, with a focus on mucosal changes. Results: All five patients had a diverting stoma. The fistula closure rate was 100% (5/5). The median time to closure was 125 days (range, 7-168). Endoscopic examination revealed vaginal mucosal neovascularization in three patients, all of whom exhibited vaginal-side primary healing. The recurrence rate was 20% (1/5), and this patient achieved successful closure after stoma reconstruction and VET readministration. No adverse events were observed. Conclusion: VET therapy following stoma creation may be an effective, non-invasive treatment option for small to moderate-sized RVF after low rectal surgery. It potentially promotes vaginal tissue regeneration and neovascularization, suggesting a novel, targeted approach to RVF healing.
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