title: Treatment of recto-vesical fistula by transanal endoscopic microsurgery approach.
abstract: BACKGROUND
  Rectovesical Fistula (RVF) is a rare major surgery complication. Despite different techniques have been proposed as yet there is still no standard treatment. Transanal Endoscopic Microsurgery provides a magnified three-dimensional vision and it is less invasive than the traditional surgical procedure used in RVF treatment.
  
  
  METHODS
  A 62 years-old man, who developed a rectovesical fistula after laparoscopic radical prostatectomy, underwent TEM-assisted RVF repair by full-thickness excision and both bladder and rectal wall suture. The patients had a temporary ileostomy
  
  
  RESULTS
  The patient could ambulate on day one, was fed on day three and was discharged on day 10 with the indwelling bladder catheter left in place. The ileostomy was taken down and the catheter removed three months later when colonoscopy and cystoscopy showed no rvf recurrence.
  
  
  CONCLUSIONS
  From 2004, only ten cases of TEM-assisted treatment of RVF are reported with three recurrences and good results even in patients who had already undergone previous surgical attempts. TEM is safe and effective. It provides a tension free suture line on healthy tissue with adequate hemostasis and it may be a good alternative in the treatment of rectovesical fistula.
  
  
  BACKGROUND
  Endoscopic Surgery, Microsurgery, Recto-vesical Fistula, Transanal Endoscopic.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: D'Ambrosio
authors.forename: Gianfrancesco
authors.initials: G
authors.lastname: Intini
authors.forename: Andrea
authors.initials: A
authors.lastname: Picchetto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Campo
authors.forename: Andrea
authors.initials: A
authors.lastname: Balla
authors.forename: Silvia
authors.initials: S
authors.lastname: Quaresima
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Paganini
authors.forename: Emanuele
authors.initials: E
authors.lastname: Lezoche
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000628:therapy; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D013536:Suture Techniques; D000067369:Transanal Endoscopic Microsurgery; D001747:Urinary Bladder Fistula / Q000209:etiology / Q000601:surgery*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents