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Case Reports
. 2013 Jun;8(2):162-5.
doi: 10.5114/wiitm.2011.32808. Epub 2013 Jan 16.

Laparoscopic conservative surgery of colovesical fistula: is it the right way?

Cochetti Giovanni  1 , Cottini Emanuele, Cirocchi Roberto, Pansadoro Alberto, Lepri Emanuele, Corsi Alessia, Barillaro Francesco, Mearini Ettore
Affiliations
Case Reports

Laparoscopic conservative surgery of colovesical fistula: is it the right way?

Cochetti Giovanni et al. Wideochir Inne Tech Maloinwazyjne. 2013 Jun.

Abstract

Enterovesical fistula is a rare disease. The standard treatment of colovesical fistula is removal of the fistula, suture of the bladder wall, and colic resection with or without temporary colostomy. The usual approach is open because the laparoscopic one has high conversion rates and morbidity. We report the first laparoscopic conservative treatment of colovesical fistula in our knowledge and its long-term results. A 69-year-old man was affected by colovesical fistula due to endoscopic exeresis of a 2 cm adenomatous polyp in the sigmoid diverticulum. We performed a laparoscopic conservative treatment of the fistula without colic resection. Operative time was 210 min and estimated blood loss was 300 ml. The catheter was removed after 10 days. Time to first flatus was 2 days and the hospital stay was 8 days. No peri- or post-operative complications occurred. At 48-month follow-up fistula did not recur. Laparoscopic conservative surgery for colovesical fistula is safe and feasible. It could be a therapeutic option in selected cases, especially if diverticular disease and inflammation are slight.

Keywords: colon resection; colovesical fistula; diverticular disease; laparoscopic conservative treatment.

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Figures

Photo 1
Photo 1
The fistulous tract was clipped
Photo 2
Photo 2
The fistulous tract was removed
Photo 3
Photo 3
Post-operative cystourethrogram shows absence of leakage
See this image and copyright information in PMC

References

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