title: Outcome of colonic fistula surgery in the modern surgical era.
abstract: BACKGROUND
  Various conditions lead to the development of colonic fistulas. Contemporary surgical data is scarce and it is unclear whether advances in surgical care have impacted outcome. The aim of the present study was to review the short- and long-term outcome of patients treated surgically for colonic fistula over an 8-year period at a tertiary institution.
  
  
  METHODS
  A retrospective review was performed, focusing on the type of operative interventions, short- and long-term complications, length of hospital stay, readmission rate, mortality rate, and fistula recurrence.
  
  
  RESULTS
  Forty-five patients were treated for colonic fistula. The most common etiology was diverticulitis (74%). Fistula type was colovesical (58%), colocutaneous (18%) and colovaginal (15%). Laparoscopic resection was performed in 42% of cases. An intraoperative complication occurred in 4%. A primary anastomosis was performed in 96% of patients and 10 (23%) had a temporary stoma. Median length of hospital stay was 6 days. Postoperative complications were common (47%) and wound infection was noted in 20% of patients. The readmission rate was 29% and the 90-day mortality was 4%. All patients healed their fistula with no recurrences noted during a median follow-up of 37 months.
  
  
  CONCLUSIONS
  Surgical intervention healed the majority of patients with colonic fistula. However postoperative complications were common and readmission occurred in one-third of the cases. Laparoscopic excision was feasible in nearly half of the patients.
authors.affiliation: Department of Surgery, Kaiser Permanente, 4760 Sunset Boulevard, 3rd Floor, Los Angeles, CA, 90027, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Tam
authors.forename: M
authors.initials: M
authors.lastname: Abbass
authors.forename: A T
authors.initials: AT
authors.lastname: Tsay
authors.forename: M A
authors.initials: MA
authors.lastname: Abbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003108:Colonic Diseases / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000401:mortality / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome