Risk factors associated with postoperative morbidity in over 500 colovesical fistula patients undergoing colorectal surgery: a retrospective cohort study from ACS-NSQIP database

Aydinli, H. Hande; Benlice, Çiğdem; Özüner, Gökhan; Görgün, Emre; Abbas, Maher A.

doi:10.1007/s00384-016-2721-4

Cited by 16 publications

(19 citation statements)

References 14 publications

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“…There are few high-quality studies investigating the management of persistent abscesses and fistulas due to diverticulitis. Some descriptive case series, focusing either on the open or the laparoscopic approach, supported resection with primary anastomosis when possible and contextual bladder resection if needed [164][165][166][167][168][169][170][171][172]. Only one small retrospective cohort study investigated laparoscopic vs open surgery, demonstrating similar results [173].…”

Section: What Is the Role Of Restoration Of Intestinal Continuity Witmentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

168

177

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Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

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Section: What Is the Role Of Restoration Of Intestinal Continuity Witmentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

168

177

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“…La presencia de aire intravesical en la TC abdominal confirma dicho diagnóstico. 5,10,20 En nuestra serie de casos, la clínica fue el dato desencadenante para iniciar los protocolos de estudio, todos nuestros pacientes fueron sujetos a los procedimientos estipulados, mediante la realización de una TC abdominopélvica, colonoscopía y colon por enema (Figura 1).…”

Section: Discussionunclassified

“…Con una adecuada selección de pacientes, el abordaje por laparoscopía puede ser factible. 20,26,27 En las series publicadas más recientemente sobre fístula colovesical se reportan porcentajes de abordaje laparoscópico de entre 30 y 100%, y tasas de conversión de 10 a 30%, sin diferenciar el origen de la fístula. 25,27 Las series más significativas son la de Aydinli y su grupo, 20 con 512 pacientes: 473 con fístula de origen benigno y 30% intervenidos por laparoscopía; y la de Cirocchi y su equipo 25 con 202 casos de fístulas de origen benigno intervenidos todos ellos por laparoscopía.…”

Section: Discussionunclassified

“…20,26,27 En las series publicadas más recientemente sobre fístula colovesical se reportan porcentajes de abordaje laparoscópico de entre 30 y 100%, y tasas de conversión de 10 a 30%, sin diferenciar el origen de la fístula. 25,27 Las series más significativas son la de Aydinli y su grupo, 20 con 512 pacientes: 473 con fístula de origen benigno y 30% intervenidos por laparoscopía; y la de Cirocchi y su equipo 25 con 202 casos de fístulas de origen benigno intervenidos todos ellos por laparoscopía. Tomizawa y colaboradores 26 publicaron un estudio descriptivo retrospectivo de 39 casos con fístula colovesical por diverticulitis intervenidos mediante lapa-Tabla 1: Cuadro de resultados resaltando el procedimiento quirúrgico realizado, así como la necesidad de reparar la vejiga, el uso de azul de metileno transoperatorio y el uso de drenajes.…”

Section: Discussionunclassified

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Manejo laparoscópico de fístulas colovesicales de origen benigno, resultados y revisión de la literatura

Campo¹,

Soto²,

Mancilla³

et al. 2020

Revista Mexicana De Cirugía Endoscópica

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Las fístulas colovesicales son una entidad poco frecuente y consisten en una comunicación anormal entre el colon y la vejiga urinaria. El diagnóstico se logra mediante tomografía computarizada. El tratamiento estándar se centra en la resección de la porción involucrada del colon y, si es necesario, la reparación de la vejiga. Material y métodos: Realizamos un estudio retrospectivo, descriptivo y observacional de 10 pacientes entre 2016 y 2020 con diagnóstico de fístula colovesical. Resultados: Se obtuvo un promedio de edad de 61.2 años, 70% de los pacientes se diagnosticaron mediante tomografía axial computarizada (TAC) abdominopélvica y el 30% restante necesitó otros estudios para llegar al diagnóstico; al 100% se le realizó sigmoidectomía laparoscópica con anastomosis mecánica colorrectal, no hubo ninguna conversión, no se realizó ningún procedimiento adicional a la vejiga y 30% de los pacientes presentó dehiscencia de anastomosis, por lo que se tuvo que reintervenir y realizar colostomía. Conclusiones: El tratamiento laparoscópico de la fístula colovesical es una opción viable. La anastomosis primaria no aumenta la morbimortalidad. La reparación del lado de la vejiga de la fístula debe adaptarse al escenario clínico.

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“…Diverticulitis is the most common cause of colovesical fistula, yet it is an uncommon complication and occurs in approximately 1-4% of cases [1,2]. Patients with CVF typically present with dysuria, recurrent urinary tract infection (UTI), pneumaturia, and/or fecaluria [1,2].…”

Section: Objectivesmentioning

confidence: 99%

Early Removal of Foley Catheter after Sigmoid Colectomy for Diverticular Colovesical Fistula without Intraoperative Bladder Repair or Postoperative Cystography: Feasibility of a Quality Improvement Pilot Program

Anthony¹,

Kitamura²,

John³

et al. 2019

Int J Surg Res Pract

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Background: The treatment of colovesical fistula (CVF) due to diverticular disease is complex and imposes significant risk to the patient. Specifically, management of the bladder defect after fistula takedown is inconstant. In this quality improvement study, we report on the safety of early (< 7 days) urethral catheter removal without intraoperative or postoperative bladder imaging. Methods: Between 2008 and 2018, patients who were operated on for CVF due to diverticular disease were identified retrospectively. Medical records were reviewed to obtain patient characteristics, operative technique and findings, and postoperative outcomes. Results: Between 2008 and 2018, 17 patients with diverticulitis-induced CVF underwent fistula takedown. Bladder defects were only formally repaired if urothelium was visualized intraoperatively. Mean postoperative urethral catheterization was 5.5 days and bladder imaging was not performed intraoperatively or postoperatively. There were no urinary-related complications or mortalities, and mean follow-up was 249 ± 60 days. Conclusion: This quality improvement pilot study supports early catheter removal (< 7 days) and suggests bladder imaging may be unnecessary in select cases.

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Risk factors associated with postoperative morbidity in over 500 colovesical fistula patients undergoing colorectal surgery: a retrospective cohort study from ACS-NSQIP database

Abstract: Morbidity for CVF remains high. Lower preoperative hematocrit level and increased age were associated with higher risk of complication. Laparoscopic surgery may be preferable when possible as morbidity is less with this approach.

Cited by 16 publications

References 14 publications

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Manejo laparoscópico de fístulas colovesicales de origen benigno, resultados y revisión de la literatura

Early Removal of Foley Catheter after Sigmoid Colectomy for Diverticular Colovesical Fistula without Intraoperative Bladder Repair or Postoperative Cystography: Feasibility of a Quality Improvement Pilot Program

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