alois furstProfessional title: Professor

Date of primary qualification: 1996

Current Institution:
Department of Surgery, Caritas-Clinic St. Josef, Regensburg, Germany

Invited presentation:
Benign rectovaginal fistulas

Learning objectives:
Rectovaginal fistulas are rare but frequently a challenge for the surgeon. The rectovaginal wall is rather thin and scary due to infection or radiation therapy in the past. The problem exists sometimes also in Crohn’s patients. To close a rectovaginal fistula an individual concept is mandatory for the majority of the patients. If conventional surgical techniques fail to close the fistula tract additional surgical procedures like biological meshes or transposition of the gracilis muscles may be successful in many cases. A series of 50 patients after graciloplasty to close a rectovaginal fistula will be presented at the ESCP-congress.

Summary of clinical and research background

  • 1982-84: University of Regensburg
  • 1984-89: University of Wuerzburg, Graduation
  • 1990: Graduation: "The physiological relaxation of the M. sphincter ani internus"
  • 1992
    • Introduction and organisation of an anorectal laboratory;
    • Scientifical projects in anorectal manometry und endosonography;
    • Functional studies in sphincter preserving rectal resections;
    • Transversal und longitudinal endosonography and decision making in sphincter preserving rectal surgery
    • Prognostic factors and surgical principles in rectal cancer
  • 1994: National Multicenter Study: Adjuvant vs. neoadjuvant Radiochemotherapy in rectal cancer stage II/III CAO-94
  • 1995: Hospitation at St. Marks Clinic London (Prof. Nicholls)
  • 1996: Minimal invasive surgery in benign and malignant colorectal diseases
  • 1996-1999: Prospective randomized study „Colon-J-Pouch vs. Coloanal anastomosis in distal rectal cancer“
  • 1998: Hospitation at the Cleveland Clinic Florida (Prof. Wexner)
  • 1999: Evaluation of the Dynamic MRI of the pelvic floor
  • 2000: Prospective randomized study „Colon-J-Pouch vs. Coloplasty in distal rectal cancer”
  • 2001: Prospective randomized Multicenterstudy “Colon-J-Pouch vs. Coloplasty vs. Straight Coloanal Anastomosis in distal rectal cancer” (Prof. Fazio, Cleveland Ohio)
  • 2002: Post graduation: „Sphincter preserving surgery in rectal cancer - Functional aspects of colonic pouch procedures“
  • 2003: Interdisciplinary Center for the diagnosis and treatment of pelvic floor disorders, Assistant Professor, Department of Surgery
  • 2004: Initiation of the COLOR II-Study in Germany (Laparoscopic vs. open rectal resection in rectal cancer - A prospective randomized multicenter study)
  • 2004: Initiation of the STARR-Registry in Germany (Prospective survey of Stapled Transanal rectal resection)
  • 2007: Participation to the CAO-AIO-ARO-04-Study
  • 2008: Anal Fistula Plug Study, Solesta Study
  • 2008: Certification of the German Visceral Surgery Society (DGAV): Competence and Reference Center in Coloproctology
  • 2008: National Representative of European Society of Coloproctology
  • 2009: Introduction of a new laparoscopic Solo-surgery system
  • 2010: Certification of the German Tumor Society (DKG): Colorectal Cancer Center
  • 2012: Guideline group “Cryptoglandular fistula, anal abscess, rectovaginal fistula”
  • 2013: Short-term results : Laparoscopic versus open surgery for rectal cancer (COLOR II study group)


  • The Pennsylvania Society of Colon and Rectal Surgery Award 2002. Colonic J-Pouch vs. Coloplasty Following Resection of Distal Rectal Cancer - Early Results of a Prospective Randomized Pilot Study. A. Fürst, M. Anthuber, S. Suttner, L. Hutzel, A. Beham, K. Jauch
  • Midwest Society of Colon and Rectal Surgeons William C. Bernstein, MD, Award 2002. Adenoviral Transfer of Bax Under the Control of the CEA Promoter Induces Apoptosis in Colon Cancer Cell Lines In Vitro and in Vivo. A. Beham, M. Vogel, M. Rentsch, A. Fürst, K. Jauch
  • German Society of ColoproctologyJens-Kirsch-Award 2004. Fürst A, Suttner S, Beham A, Iesalnieks I, Swol-Ben J, Paetzel C, Schlitt HJ. Neorectal evacuation of Coloplasty versus Colonic-J-Pouch - A prospective comparative study including dynamic MRI“
  • Section of Coloproctology of the German Society of Surgery (CACP) Poster-Award 2004. Swol-Ben J, Schifferer C, Schlitt HJ, Fürst A. Quality of internet information in term of stool incontinence
  • Section of Coloproctology of the German Society of Surgery (CACP) Poster-Award 2007. Stadler F, Schmidbauer C, Schwandner O, Fürst A. Graciloplasty for closure of recurrent rectovaginal fistula

Relevant peer reviewed publications within last 5 years

  • Victor W. Fazio, MD; Massarat Zutshi, MD; Feza H. Remzi, MD; Yann Parc, MD; Reinhard Ruppert, MD; Alois Fürst, MD; James Celebrezze Jr, MD; Susan Galanduik, MD; Guy Orangio, MD; Neil Hyman, MD; Leslie Bokey, MD; Emmanuel Tiret, MD; Boris Kirchdorfer, MD; David Medich, MD; Marcus Tietze, MD; Tracy Hull, MD; Jeff Hammel, MS
  • A Randomized Multicenter Trial to Compare Long-Term Functional Outcome, Quality of Life, and Complications of Surgical Procedures for Low Rectal Cancers. Ann Surg 2007;246:481-90.
  • Bataille F, Rohrmeier C, Bates R, Weber A, Rieder F, Brenmoehl J, Strauch U, Farkas S, Fürst A, Hofstädter F, Schölmerich J, Herfarth H, Rogler G. Evidence for a role of epithelial mesenchymal transition during pathogenesis of fistulae in Crohn’s disease Inflamm Bowel Dis. 2008 Nov;14(11):1514-27
  • Agha A & Fürst A, Hierl J, Iesalnieks I, Glockzin G, Anthuber M, Jauch KW, Schlitt H. surgery for rectal cancer - oncological results and clinical outcome of 225 patients. Surg Endosc. 2008 Oct;22(10):2229-37. Epub 2008 Jul 12.
  • Agha A & Fürst A, I. Iesalnieks, S. Fichtner-Feigl, N. Ghali, D. Krenz, M. Anthuber, K.W. Jauch, P. Piso, H.J. Schlitt Conversion rate in 300 laparoscopic rectal resections and its influence on morbidity and oncological outcome Int J Colorectal Dis 2008;23:409-17.
  • Schwandner O, Stadler F, Dietl O, Wirsching R, Fürst A Initial experience on efficacy in closure of cryptoglandular and Crohn’s transsphincteric fistulas by the use of the anal fistula plug. Int J Colorectal Dis 2008;23:319-24.
  • Fürst A, Schmidbauer C, Swol-Ben J, Iesalnieks I, Schwandner O, Agha A Gracilis Transposition for Repair of Recurrent Rectovaginal Fistula in Crohn’s Disease Int J Colorectal Dis 2008;23:339-51.
  • Timmer A, Kemptner D, Bauer A, Takses A, Ott C, Fürst A. Determinants of female sexual function in inflammatory bowel disease: a survey based cross-sectional analysis. BMC Gastroenterology 2008;8:45
  • Schwandner O, Fürst A, Kunstreich K, Scherer R Innovative technique for the closure of rectovaginal fistula using Surgisis mesh Tech Coloproctol 2009; 13:135-40.
  • Bonjer HJ, Cuesta MA, Lacy AM, Haglind E, Fürst A, Lange JF, Hoop WCJ, Buunen M COLOR II A randomized clinical trial comparing laparoscopic and open surgery for rectal cancer Dan Med Bull 2009;56:89-91.
  • Schwandner O, Fürst A; German STARR Registry Study Group. Assessing the safety, effectiveness, and quality of life after the STARR procedure for obstructed defecation: results of the German STARR registry. Langenbecks Arch Surg. 2010;395:505-513.
  • Fürst A, Schwandner O, Heiligensetzer A, Iesalnieks I, Agha A. Laparoscopic TME in rectal cancer - electronic supplementary: op-video. Langenbecks Arch Surg. 2010;395:181-3.
  • Parc Y, Zutshi M, Zalinski S, Ruppert R, Fürst A, Fazio VW. Preoperative radiotherapy is associated with worse functional results after coloanal anastomosis for rectal cancer. Dis Colon Rectum. 2009 Dec;52(12):2004-14.
  • Scharl M, Weber A, Fürst A, Farkas S, Jehle E, Pesch T, Kellermeier S, Fried M, Rogler G. Potential role for snail family transcription factors in the etiology of Crohn's disease-associated fistulae. Inflamm Bowel Dis. 2011 Sep;17(9):1907-16. doi: 10.1002/ibd.21555. Epub 2010 Dec 3
  • Ommer A, Herold A, Berg E, Fürst A, Sailer M, Schiedeck T Clinical practice guideline: Cryptoglandular anal fistula. Dtsch Ärtzeblatt Int 2011; 108(42):707-13. Schneider R, Schneider C, Kloor M, Fürst A, Möslein G Lynch Syndrome: Clinical, pathological and genetic insights Langenbecks Arch Surg (2012) 397:513–525
  • Ommer A, Herold A, Berg E, Fürst A, Sailer M, Schiedeck T. German S3 guideline: anal abscess. Int J Colorectal Dis. 2012 Jun;27(6):831-7. Epub 2012 Feb 24.
  • Ommer A, Herold A, Berg E, Fürst A, Schiedeck T, Sailer M German S3-Guideline: Rectovaginal Fistula GMS German Medical Science 2012, Vol. 10, ISSN 1612-3174
  • Rödel C, Liersch T, Becker H, Fietkau R, Hohenberger W, Hothorn T, Graeven U, Arnold D, Lang-Welzenbach M, Raab HR, Sülberg H, Wittekind C, Potapov S, Staib L, Hess C, Weigang-Köhler K, Grabenbauer GG, Hoffmanns H, Lindemann F, Schlenska-Lange A, Folprecht G, Sauer R Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. German Rectal Cancer Study Group.(Fürst A) Lancet Oncol. 2012 Jul;13(7):679-87. Epub 2012 May 23
  • Schreyer AG, Paetzel C, Fürst A, Dendl LM, Hutzel E, Müller-Wille R, Wiggermann P, Schleder S, Stroszczynski C, Hoffstetter P. Dynamic magnetic resonance defecography in 10 asymptomatic volunteers. World J Gastroenterol. 2012 Dec 14;18(46):6836-42. doi: 10.3748/wjg.v18.i46.6836.
  • John Andersson, Eva Angenete, Martin Gellerstedt, Ulf Angerås, Per Jess, Jacob Rosenberg, Alois Fürst, Jaap Bonjer, Eva Haglind. Health related quality of life after laparoscopic and open surgery for rectal cancer Br J Surg (accepted)
  • van der Pas, E Haglind, MA Cuesta, A Fürst, AM Lacy, WCJ Hop and HJ Bonjer for the COlorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group Laparoscopic versus open surgery for rectal cancer: short-term outcomes of a randomized, phase 3 trial. Lancet Oncol. 2013 Mar;14(3):210-8. doi: 10.1016/S1470-2045(13)70016-0. Epub 2013 Feb

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