Progress in the application of pedicled autologous tissue in the repair of urethrorectal fistula

Abstract

The treatment of urethrorectal fistula remains challenging due to its rarity and complexity. The traditional operation mainly uses simple fistula repair, but the recurrence rate is high and the effect is poor. In recent years, a number of clinical retrospective studies have proved the feasibility of placing various kinds of pedicled tissue flap between the rectum and urethra, and its application has provided a new solution for the treatment of urethral rectal fistula, and achieved satisfactory results. Compared with traditional fistula repair, pedicled tissue flap has sufficient tissue thickness and clear blood supply, which makes up for the thin tissue and poor blood supply of urethral anastomosis and rectal fistula in traditional surgery, and significantly reduces the postoperative recurrence rate of urethral rectal fistula. On the other hand, there are differences in surgical approaches due to the different etiology, location, size of fistula mouth, and doctors' preferences. The anatomy and blood supply of all kinds of autologous pedicled tissue flaps also determine their clinical application. As a common disease of urology and colorectal surgery, the multidisciplinary collaboration of consultation and treatment has brought more options for the management of urethral rectal fistula. Based on this, in this paper, the application of various pedicled autologous tissues in the repair of urethrorectal fistula is reviewed, and different types of tissues are classified according to the surgical approach. The anatomy, blood supply, clinical application, indications, advantages and disadvantages of commonly used autogenous pedicled tissue are discussed in order to provide some reference for the repair of urethrorectal fistula.