medric medric
[닫기]
잠시만 기다려 주세요. 로딩중입니다.

Colovesical Fistula: Should It Be Considered a Single Disease?

대한대장항문학회지 2015년 31권 2호 p.57 ~ 62
 ( Kiani Qamar-Hafeez ) - Guys and St. Thomas NHS Trust Department of Colorectal Surgery

 ( George Mark L. ) - Guys and St. Thomas NHS Trust Department of Colorectal Surgery
 ( Carapeti Emin-A. ) - Guys and St. Thomas NHS Trust Department of Colorectal Surgery
 ( Schizas Alexis M. P. ) - Guys and St. Thomas NHS Trust Department of Colorectal Surgery
 ( Williams Andrew-B. ) - Guys and St. Thomas NHS Trust Department of Colorectal Surgery

Abstract


Purpose
This research was conducted to compare the management and the outcome of patients with colovesical fistulae of different aetiologies.

Methods
Retrospective data were collected from 2002 to 2012 and analyzed with SPSS ver. 17. Age, gender, aetiology, management, hospital stay, postoperative complications, and mortality were studied and compared among colovesical fistulae of different aetiologies.

Results
A total of 55 patients, 46 males (84%) and 9 females (16%), with a median age of 65 years (interquartile range [IQR], 48-75 years) were studied. Diverticular disease was the most common benign cause and recto-sigmoid cancer the most common malignancy. Anterior resection and bladder repair were the most frequent operations in benign cases, as was total pelvic exenteration in the malignant group. Multiple intestinal loop involvement and subsequent resection were significantly higher in those with Crohn disease than it was in patients of colovesical fistula due to all other causes collectively (60% vs. 6%, P = 0.006). Patients with malignancy had a higher postoperative complication rate than patients who did not (12 [80%] vs. 7 [32%], P = 0.0005). Pelvic collection (11, 22%) was the most frequent early complication (predominantly in the malignant group) whereas incisional hernia (8, 22%) was the most common late complication, with a predominance in the benign group. The median hospital stay was significantly prolonged in the malignant group (32 days; IQR, 17-70 days vs. 16 days; IQR, 11-25 days; P < 0.001).

Conclusion
Despite their having similar clinical presentation, colovesical fistulae of various aetiologies differ significantly in management and outcome.

키워드

Colovesical fistula; Fistula; Pelvic exenteration; Diverticulitis; Adenocarcinoma
원문 및 링크아웃 정보
 
등재저널 정보
KCI
KoreaMed
KAMS