A Case of Rectovaginal Fistula after Transanal Total Mesorectal Excision for Rectal Cancer with Achievement of Complete Remission with Estriol

Abstract

A 42-year-old woman underwent transanal total mesorectal excision (TaTME) with a covering ileostomy for rectal cancer (Rb). She was discharged 16 days after surgery without any major problems. Since the cancer was pT2N1aM0 Stage IIIa, the covering ileostomy was closed after postoperative adjuvant chemotherapy. One week after discharge, a rectovaginal fistula became apparent. The patient was administered estriol tablets alone, which resulted in the rectovaginal fistula healing after approximately 2 months. Rectovaginal fistula is usually difficult to relieve with conservative treatment alone, and invasive treatment is often required. However, in recent years, reports of improvement with estriol administration have suggested that this may be a minimally invasive and effective conservative treatment for postoperative rectovaginal fistula.