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Laparoscopic surgery for fistulas that complicate diverticular disease.
Langenbecks Arch Surg. 2003 Jul; 388(3):189-93.LA

Abstract

BACKGROUND

Diverticular disease is complicated by colovesical and colovaginal fistulas in 4-20% of patients. Laparoscopic surgery is usually reserved for selected cases of uncomplicated disease. The aim of this study was to assess the efficacy and effectiveness of laparoscopic surgery in the treatment of those patients.

METHODS

Eighteen patients, 15 with colovesical fistulas and three with colovaginal fistulas, were operated on laparoscopically. Prospectively collected data, associated with technical feasibility, short-term outcome and effectiveness, were analysed.

RESULTS

Twelve sigmoidectomies, four extended left colectomies and two segmentectomies were performed. Fistulas were treated with simple dissection or mechanical division, and the bladder wall was repaired in two patients. Mean operating time was 237 min (range 165-330). There was one conversion (5.5%) and no post-operative death. Morbidity was 27.7% and included one major complication. Return of gastrointestinal function occurred 2.9 days post-operatively, and the mean hospital stay was 10 days after surgery. During the 5.1-year follow-up period there was one fistula recurrence (5.5%) and no recurrent diverticulitis.

CONCLUSIONS

Laparoscopic one-stage surgery was technically feasible and safe, with low morbidity. Effectiveness appears favourable when compared with open surgery, but prospective randomized studies are necessary to support such a conclusion.

Authors+Show Affiliations

Menenakos E
Department of General Surgery, Hôpital Cantonal de Fribourg, Fribourg, Switzerland. evmenenakos@hotmail.com
Hahnloser D
No affiliation info available
Nassiopoulos K
No affiliation info available
Chanson C
No affiliation info available
Sinclair V
No affiliation info available
Petropoulos P
No affiliation info available

MeSH

AgedColectomyColon, SigmoidColonic DiseasesDiverticulitis, ColonicFemaleFollow-Up StudiesHumansIntestinal FistulaLaparoscopyLength of StayMaleTime FactorsUrinary Bladder FistulaVaginal Fistula

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

12836027

Citation

Menenakos, Evangelos, et al. "Laparoscopic Surgery for Fistulas That Complicate Diverticular Disease." Langenbeck's Archives of Surgery, vol. 388, no. 3, 2003, pp. 189-93.
Menenakos E, Hahnloser D, Nassiopoulos K, et al. Laparoscopic surgery for fistulas that complicate diverticular disease. Langenbecks Arch Surg. 2003;388(3):189-93.
Menenakos, E., Hahnloser, D., Nassiopoulos, K., Chanson, C., Sinclair, V., & Petropoulos, P. (2003). Laparoscopic surgery for fistulas that complicate diverticular disease. Langenbeck's Archives of Surgery, 388(3), 189-93.
Menenakos E, et al. Laparoscopic Surgery for Fistulas That Complicate Diverticular Disease. Langenbecks Arch Surg. 2003;388(3):189-93. PubMed PMID: 12836027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic surgery for fistulas that complicate diverticular disease. AU - Menenakos,Evangelos, AU - Hahnloser,Dieter, AU - Nassiopoulos,Konstantinos, AU - Chanson,Christian, AU - Sinclair,Victoria, AU - Petropoulos,Panayiotis, Y1 - 2003/06/26/ PY - 2002/12/02/received PY - 2003/05/21/accepted PY - 2003/7/2/pubmed PY - 2004/1/22/medline PY - 2003/7/2/entrez SP - 189 EP - 93 JF - Langenbeck's archives of surgery JO - Langenbecks Arch Surg VL - 388 IS - 3 N2 - BACKGROUND: Diverticular disease is complicated by colovesical and colovaginal fistulas in 4-20% of patients. Laparoscopic surgery is usually reserved for selected cases of uncomplicated disease. The aim of this study was to assess the efficacy and effectiveness of laparoscopic surgery in the treatment of those patients. METHODS: Eighteen patients, 15 with colovesical fistulas and three with colovaginal fistulas, were operated on laparoscopically. Prospectively collected data, associated with technical feasibility, short-term outcome and effectiveness, were analysed. RESULTS: Twelve sigmoidectomies, four extended left colectomies and two segmentectomies were performed. Fistulas were treated with simple dissection or mechanical division, and the bladder wall was repaired in two patients. Mean operating time was 237 min (range 165-330). There was one conversion (5.5%) and no post-operative death. Morbidity was 27.7% and included one major complication. Return of gastrointestinal function occurred 2.9 days post-operatively, and the mean hospital stay was 10 days after surgery. During the 5.1-year follow-up period there was one fistula recurrence (5.5%) and no recurrent diverticulitis. CONCLUSIONS: Laparoscopic one-stage surgery was technically feasible and safe, with low morbidity. Effectiveness appears favourable when compared with open surgery, but prospective randomized studies are necessary to support such a conclusion. SN - 1435-2443 UR - https://www.unboundmedicine.com/medline/citation/12836027/Laparoscopic_surgery_for_fistulas_that_complicate_diverticular_disease_ DB - PRIME DP - Unbound Medicine ER -