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Laparoscopic conservative treatment of colo-vesical fistulas following trauma and diverticulitis: report of two different cases

  • Case Report
  • Published:
Central European Journal of Medicine

Abstract

Introduction

The standard treatment of colovesical fistula is the removal of fistula, suture of bladder wall, and then colic resection with or without temporary colostomy. The open approach is more commonly used because the laparoscopic approach seems to have high conversion rates and morbidity. We report two cases of colovesical fistula treated with a laparoscopic conservative approach. We also focus on the long term outcome. Case presentation 1. A 69-year-old male with colovesical fistula that appeared after endoscopic polipectomy in the sigmoid diverticulum underwent a totally laparoscopic conservative treatment without colic resection. Operative time was 210 minutes and blood loss was 300 ml. Time to bowel movement was 60 hours. No complications or fistula recurrence occurred at 48-month follow-up. Case presentation 2. A 34-year-old male with colovesical fistula secondary to diverticulitis underwent totally laparoscopic conservative surgery. Operative time was 160 minutes and blood loss was 150 ml. Time to bowel movement was 72 hours. Fistula reoccurred two weeks after discharge. We performed Hartmann’s procedure and defunctioning colostomy with an open approach. No recurrence or complications were found at 36 months follow up.

Conclusion

The laparoscopic conservative treatment of colovesical fistula is a safe and feasible technique. When there is no diverticular disease, the conservative approach is very effective.

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Authors and Affiliations

  1. Department of Medical-Surgical Specialties and Public Health, Urological Andrological Surgery and Minimally Invasive Techniques, University of Perugia, Terni, Italy

    Cochetti Giovanni, Lepri Emanuele, Cottini Emanuele, Barillaro Francesco, Boni Andrea, Mancuso Rosa, Solajd Pohja & Mearini Ettore

  2. Department of General Surgery, University of Perugia, St. Maria Hospital, Terni, Italy

    Cirocchi Roberto & Alessia Corsi

Authors
  1. Cochetti Giovanni
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  2. Lepri Emanuele
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  3. Cottini Emanuele
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  4. Cirocchi Roberto
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  5. Alessia Corsi
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  6. Barillaro Francesco
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  7. Boni Andrea
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  8. Mancuso Rosa
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  9. Solajd Pohja
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  10. Mearini Ettore
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Correspondence to Cochetti Giovanni.

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Giovanni, C., Emanuele, L., Emanuele, C. et al. Laparoscopic conservative treatment of colo-vesical fistulas following trauma and diverticulitis: report of two different cases. cent.eur.j.med 8, 790–794 (2013). https://doi.org/10.2478/s11536-013-0195-0

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  • DOI: https://doi.org/10.2478/s11536-013-0195-0

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