title: Laparoscopic conservative surgery of colovesical fistula: is it the right way?
abstract: Enterovesical fistula is a rare disease. The standard treatment of colovesical fistula is removal of the fistula, suture of the bladder wall, and colic resection with or without temporary colostomy. The usual approach is open because the laparoscopic one has high conversion rates and morbidity. We report the first laparoscopic conservative treatment of colovesical fistula in our knowledge and its long-term results. A 69-year-old man was affected by colovesical fistula due to endoscopic exeresis of a 2 cm adenomatous polyp in the sigmoid diverticulum. We performed a laparoscopic conservative treatment of the fistula without colic resection. Operative time was 210 min and estimated blood loss was 300 ml. The catheter was removed after 10 days. Time to first flatus was 2 days and the hospital stay was 8 days. No peri- or post-operative complications occurred. At 48-month follow-up fistula did not recur. Laparoscopic conservative surgery for colovesical fistula is safe and feasible. It could be a therapeutic option in selected cases, especially if diverticular disease and inflammation are slight.
authors.affiliation: Department of Surgical Specialties, Urological Andrological Surgery and Minimally Invasive Techniques, University of Perugia, Terni, Italy.
authors.forename: Cochetti
authors.initials: C
authors.lastname: Giovanni
authors.forename: Cottini
authors.initials: C
authors.lastname: Emanuele
authors.forename: Cirocchi
authors.initials: C
authors.lastname: Roberto
authors.forename: Pansadoro
authors.initials: P
authors.lastname: Alberto
authors.forename: Lepri
authors.initials: L
authors.lastname: Emanuele
authors.forename: Corsi
authors.initials: C
authors.lastname: Alessia
authors.forename: Barillaro
authors.initials: B
authors.lastname: Francesco
authors.forename: Mearini
authors.initials: M
authors.lastname: Ettore
keywords: colon resection; colovesical fistula; diverticular disease; laparoscopic conservative treatment