TREATMENT OF RADIATION-INDUCED COLOVAGINAL FISTULA WITH AUTOLOGOUS FAT GRAFTING

In 20-30% of patients who undergo radiotherapy of the pelvic organs late radiation injury of rectum develops that can lead to a fistula formation. Effective treatment of radiation-induced rectovaginal fistula is a challenging problem. Temporary recovery can be achieved only in 35-65% of such patients and the relapse rate is about 80%.The paper presents a clinical case of recurrent postoperational colovaginal fistula of colo-anal anastomosis region. Based on our experience in treatment of external localization chronic radiation wounds, fat grafting and adipose-derived stromal-vascular fraction was offered as a salvage treatment of radiation-induced rectovaginal fistula. The assumed effect of the procedure is restoration of reparative regeneration of damaged tissues with subsequent fistula healing. As a result of two injections of 30 ml of refined lipoaspirate and stromal-vascular fraction into rectovaginal septum, complete healing of recurrent colovaginal fistula was accomplished in 10 months after treatment. Other methods were not used. Important observation was the absence of rectovaginal fistula relapse over 3-month period after restoration of natural defecation.

поздние лучевые повреждения, постлучевой коловагинальный свищ, микроинъекционная аутотранс-плантация жировой ткани, липофилинг, липографтинг, стромальные клетки жировой ткани, late adverse effects of radiotherapy, postirradiation rectovaginal fistula, аutologous fat grafting, adipose-derived stromal cells, lipofilling, lipografting, stromal cells of adipose tissue

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