Rectovaginal fistula: complication of low anterior resection

Three hundred of 990 active members (30 percent) of The American Society of Colon and Rectal Surgeons responded to a survey regarding the incidence of rectovaginal fistulas following low anterior resection. A total of 57 patients were reported to have had postoperative rectovaginal fistulas; of these, 53 had circular-stapled anastomoses. Patient characteristics, surgeon's experience, technical methods, pathology, and methods of treatment were surveyed. As lower resections for rectal sparing are attempted, this emerging complication must be recognized and avoided.