title: Evaluating surgical management and outcomes of colovaginal fistulas.
abstract: BACKGROUND
  Colovaginal fistula is a rare condition associated with significant morbidity. The literature characterizing colovaginal fistula repair is sparse. We present our institution's experience treating colovaginal fistulas.
  
  
  METHODS
  A retrospective review of all patients surgically treated for colovaginal fistula between 2005 and 2015 was performed. Patient demographics, intra-operative details, and post-operative outcomes were reviewed.
  
  
  RESULTS
  We identified 27 patients with a mean age of 71 (±13) and BMI of 30 (±9). The most common etiology for fistula was diverticulitis (n = 24, 89%). A laparoscopic approach was initiated in 19 patients (70%) and an open approach for 8 (30%) with 8 patients converted from laparoscopy to open (42%). At a mean follow-up of 18 months (±21), there were no recurrences.
  
  
  CONCLUSIONS
  We present one of the largest series of the surgical management of colovaginal fistulas. Although our conversion rate was high, we recommend a laparoscopic approach be utilized when feasible.
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Wen
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Althans
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA. Electronic address: Justin.Brady@UHhospitals.org.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Brady
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Eslam M G
authors.initials: EM
authors.lastname: Dosokey
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Dongjin
authors.initials: D
authors.lastname: Choi
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Madhuri
authors.initials: M
authors.lastname: Nishtala
authors.affiliation: Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Conor P
authors.initials: CP
authors.lastname: Delaney
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: D000368:Aged; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D004239:Diverticulitis, Colonic / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014624:Vaginal Fistula / Q000209:etiology / Q000601:surgery*
keywords: Colovaginal; Diverticulitis; Fistula; Laparoscopy