Minimally invasive endoscopic repair of rectovaginal fistula

Table 2 Details and results of the endoscopic repair approaches for rectovaginal fistulas

Number	Endoscopic repair	Operative time (min) and hospital-stay (d)	Follow-up (mo)	Resultsa	Complication
1	TEMS + fistulectomy + suturing (n = 13)	130 min (range, 90-150 min); 5 d (range, 3-8 d)	25	93% closed	Hematoma of the septum (n = 1); Abscess of the septum (n = 1); Moderate sphincter hypotonia (n = 1)
2	Endoscopic stenting (n = 15)	Unclear; Unclear	22 (range, 4-39)	80% closed	Pain (n = 1); Too uncomfortable to tolerate the stent (n = 1)
3	TEMS + fistulectomy + suturing (n = 4); TEMS + RAF (n = 1)	Unclear; Unclear	5 (range, 1-68)	40% closed	No complication
4	TEMS + VAF (n = 6); TEMS exploration + VAF (n = 6); TEMS + transvaginal suturing (n = 3); TES exploration + transvaginal suturing (n = 2)	75 min (range, 60-120 min); 8.29 d (range, 2-24 d)	8 (range, 2-24)	82.4% closed	No complication
5	OTSCs (n = 16)	Unclear; Unclear	10.2 (range, 8-36)	43.7% closed	Pain (n = 4); Spontaneous clip detachment (n = 1)
6	Endoscopic injection of fibrin glue (n = 1)	Few min; 0 d	12	Closed successfully	No complication
7	TEMS + RAF (n = 1)	Unclear; 2 d	6	Closed successfully	No complication
8	TTSCs (n = 1)	Unclear; Unclear	12	Closed successfully	Minimal flatus from vaginal (n = 1)
9	TEMS + suturing (n = 1)	125 min; 7d	12	Closed successfully	No complication
10	TEMS + stratified suturing (n = 1)	40 min; 2 d	12	Closed successfully	No complication
11	TTSCs (n = 1)	Unclear; Unclear	13	Closed successfully	No complication

^aSuccess rate (%) for retrospective or prospective studies, closed successfully or unsuccessfully for case reports.

TEMS: Transanal endoscopic microsurgery; OTSC: Over-the-scope clip; TTSC: Through-the-scope clip; RAF: Rectal advancement flap; VAF: Vaginal advancement flap.