Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2020; 8(22): 5645-5656
Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5645
Rectoseminal vesicle fistula after radical surgery for rectal cancer: Four case reports and a literature review
Zhi-Xiu Xia, Jin-Chun Cong, Hong Zhang
Zhi-Xiu Xia, Jin-Chun Cong, Hong Zhang, Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Xia ZX designed and drafted the manuscript, collaborated in the patient’s perioperative care and performed pathological analysis; Zhang H and Cong JC performed the operations, reviewed and revised the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Written informed consents were obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Xiu Xia, PhD, Assistant Professor, Surgeon, Lecturer, Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110001, Liaoning Province, China. 18940258100@163.com
Received: May 22, 2020
Peer-review started: May 22, 2020
First decision: September 14, 2020
Revised: September 16, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: November 26, 2020
Processing time: 186 Days and 22.9 Hours
Abstract
BACKGROUND

A rectoseminal vesicle fistula (RSVF) is a rare complication after anterior or low anterior proctectomy for rectal cancer mainly due to anastomotic leakage (AL). Limited literature documenting this rare complication is available. We report four such cases and review the literature to investigate the etiology, clinical manifestations, and the diagnostic and treatment methods of RSVF in order to provide greater insight into this disorder.

CASE SUMMARY

Four cases of RSVF were presented and summarized, and a further 12 cases selected from the literature were discussed. The main clinical symptoms in these patients were pneumaturia, fever, scrotal swelling and pain, anal pain, orchitis, diarrhea, dysuria, epididymitis and fecaluria. Imaging methods such as pelvic X-ray, computed tomography (CT), sinus radiography, barium enema and other techniques confirmed the diagnosis. CT was the imaging modality of choice. In cases presenting with reduced levels of AL, minimal surrounding inflammation, and controlled infection, the RSVF was conservatively treated by urethral catheterization, antibiotics administration and parenteral nutrition. In cases of severe RSVF, incision and drainage of the abscess or fistula and urinary or fecal diversion surgery successfully resolved the fistula.

CONCLUSION

This study provides an extensive analysis of RSVF, and outlines, summarizes and examines the causes, clinical manifestations, diagnostic procedures and treatment options, in order to prevent misdiagnosis and treatment errors.

Keywords: Case report, Seminal vesicles, Proctectomy, Anastomotic leakage, X-ray computed, Tomography

Core Tip: A rectoseminal vesicle fistula (RSVF) is a rare complication after anterior or low anterior proctectomy for rectal cancer mainly due to anastomotic leakage. Four cases of RSVF were presented and summarized, and additional12 cases selected from the literature were reviewed and discussed. This study provides an extensive analysis of RSVF, and outlines, summarizes and examines the causes, clinical manifestations, diagnostic procedures and treatment options, in order to prevent misdiagnosis and treatment errors.