Conservative treatment of rectovesical fistula after leakage following laparoscopic radical resection of rectal cancer

Abstract

Rectovesical fistula (RVF) is a multifactorial complication that can be caused by different types of laparoscopic surgery, malignant tumor invasion, and chronic inflammation. However, RVF as a postoperative complication of laparoscopic radical rectal cancer is rare and serious. Here, we describe the case of a patient with RVF secondary to pelvic infection that was induced by anastomotic leakage. The patient was managed with conservative treatment, which included doublecavity cannula irrigation-drainage, indwelling balloon urethral catheter, treating the urinary tract infection, partial parenteral nutrition, and enteral nutrition. The patient was discharged after his symptoms had improved. In this case report, we provide a feasible scheme for patients with RVF that is induced by postoperative anastomotic fistula. Inflammatory, infectious, and thrombotic factors are presumable factors that are involved in RVF pathogenesis. These findings provide new directions for the study of RVF induced by anastomotic leakage after rectal cancer surgery. Conservative treatment may be an option in patients who want to avoid an ostomy.

Evaluation and Management of Genitourinary Emergencies in Patients with Cancer

“…It remains a challenging condition owing to its complexity and rarity. Because it can lead to severe UTI, fecaluria, pneumaturia, and urine in the rectum, it seriously affects the patient's quality of life [ 65 ]. Surgical approaches for rectovesical fistula vary, and there is no consensus regarding the ideal approach for repair.…”

A Case of Rectovesical Fistula Following Blunt Trauma in a Child

“…Rectovesical fistulas are very rare and can be caused by congenital anorectal malformations, bladder and prostate surgery, gynecologic and colorectal surgery, radiotherapy for pelvic tumors, trauma, and neglected foreign bodies [ 1 ]. Pneumaturia is the most common and pathognomonic symptom.…”

Therapeutic difficulties in vesicorectal fistula treatment using several techniques in one center

“…[1][2][3][4] Clinical symptoms of the VRF include persistent infections of the urinary tract, pneumaturia, fecaluria, and presence of urine in the stool. 5 Diagnosis of VRF usually relies on the examination of the rectum. It can also be discovered by urethrocystoscopy or cystography.…”