Outcome of surgery for colovesical and colovaginal fistulas of diverticular origin in 40 patients.
J Gastrointest Surg
; 16(8): 1559-65, 2012 Aug.
Article
em En
| MEDLINE
| ID: mdl-22653331
ABSTRACT
INTRODUCTION:
According to literature, colonic resection with a primary anastomosis and no defunctioning ileostomy is a safe treatment for colovesical or colovaginal fistula of diverticular origin. This study investigates the outcome of surgery for this patient group in a regional hospital.METHODS:
Patients were obtained from a prospective database in the period 2004-2011. Several variables were investigated for their relation with surgical outcome.RESULTS:
A colovesical (n = 35) or colovaginal (n = 5) fistula was diagnosed in 18 men and 22 women. The mean age was 69 years (range, 45-90). A rectosigmoid resection with primary anastomosis was performed in 32 patients. Fourteen patients received a defunctioning ileostomy. Eight patients were treated with a Hartmann procedure. Overall 30-day treatment-related morbidity and mortality was 48 and 8 %, respectively. Major morbidity, because of anastomotic leakage, was mainly observed in the primary anastomosis group without a defunctioning ileostomy. Morbidity and mortality were associated with high body mass index, diabetes, use of corticosteroids, and American Society of Anesthesiologists classification, though not significantly.CONCLUSIONS:
One should be liberal in the use of a defunctioning ileostomy in case of a primary anastomosis after colonic resection for a diverticular fistula, in order to prevent high morbidity rates due to anastomotic leakage.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Reto
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Colo Sigmoide
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Fístula da Bexiga Urinária
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Fístula Intestinal
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Fístula Vaginal
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Doenças do Colo
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Doença Diverticular do Colo
Tipo de estudo:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article