Gracilis interposition in fistulas following radiotherapy for cervical cancer. A retrospective study

Irradiation fistulas following treatment for cervical cancer are a great challenge even to a skilled surgeon. Because of ischemia and necrosis around the fistula, repair is possible only by interposition of viable tissue. Interposition of 1 or 2 mm gracilis has been used at Sabbatsberg Hospital since the beginning of the 1950's. 27 vesicovaginal fistulas have been treated with this method, with a cure rate of 60%. The corresponding cure rate for 16 rectovaginal fistulas was 43%. The mean diameter of the fistulas was 2.5 cm. Considering the unfavorable circumstances caused by radiotherapy, in some cases combined with fulguration, these results seem satisfactory.