Types and efficacy of tissue Interposition Flaps used in the treatment of vesicovaginal fistula: A scoping review of the literature

In this study, we reviewed all available autologous and synthetic materials used for tissue interposition in vesicovaginal fistula (VVF) repair. The materials were defined for their biomaterial properties and their surgical outcomes. Research on the use of tissue interposition flaps in VVF repair is a broad area where a very wide range of natural and synthetic materials have been used in clinical studies that vary from case studies to randomized controlled trials with heterogeneity at all aspects of the clinical research. The occurrence of VVF is diverse in the social and clinical settings, resulting in a parallel heterogeneity in the published literature on its treatment. Synthetic and autologous flaps have been used without robust clinical evidence on the most efficacious type and technique of the tissue interposition flap.

本研究回顾了所有可用于膀胱阴道瘘（vesicovaginal fistula, VVF）修补术中组织植入的自体与合成生物材料，并基于生物材料属性及手术预后效果对各类材料进行了明确界定。针对膀胱阴道瘘修补术中组织植入瓣应用的研究领域较为宽泛，临床研究中已使用了种类繁多的天然与合成材料，研究类型涵盖个案报告至随机对照试验，且临床研究各维度均存在显著异质性。膀胱阴道瘘的发病情况在社会与临床场景中呈现多样化特征，这使得相关治疗的已发表文献同样存在平行异质性。目前临床已应用合成与自体组织瓣，但关于组织植入瓣的最优有效类型与手术技术，尚缺乏充分可靠的临床证据支持。