Laparoscopic surgery for fistulas that complicate diverticular disease.

Détails

ID Serval
serval:BIB_BB0364FF5EB9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Laparoscopic surgery for fistulas that complicate diverticular disease.
Périodique
Langenbeck's Archives of Surgery / Deutsche Gesellschaft Für Chirurgie
Auteur(s)
Menenakos E., Hahnloser D., Nassiopoulos K., Chanson C., Sinclair V., Petropoulos P.
ISSN
1435-2443 (Print)
ISSN-L
1435-2443
Statut éditorial
Publié
Date de publication
2003
Volume
388
Numéro
3
Pages
189-193
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal ArticlePublication Status: ppublish
Résumé
BACKGROUND: Diverticular disease is complicated by colovesical and colovaginal fistulas in 4-20% of patients. Laparoscopic surgery is usually reserved for selected cases of uncomplicated disease. The aim of this study was to assess the efficacy and effectiveness of laparoscopic surgery in the treatment of those patients.
METHODS: Eighteen patients, 15 with colovesical fistulas and three with colovaginal fistulas, were operated on laparoscopically. Prospectively collected data, associated with technical feasibility, short-term outcome and effectiveness, were analysed.
RESULTS: Twelve sigmoidectomies, four extended left colectomies and two segmentectomies were performed. Fistulas were treated with simple dissection or mechanical division, and the bladder wall was repaired in two patients. Mean operating time was 237 min (range 165-330). There was one conversion (5.5%) and no post-operative death. Morbidity was 27.7% and included one major complication. Return of gastrointestinal function occurred 2.9 days post-operatively, and the mean hospital stay was 10 days after surgery. During the 5.1-year follow-up period there was one fistula recurrence (5.5%) and no recurrent diverticulitis.
CONCLUSIONS: Laparoscopic one-stage surgery was technically feasible and safe, with low morbidity. Effectiveness appears favourable when compared with open surgery, but prospective randomized studies are necessary to support such a conclusion.
Mots-clé
Aged, Colectomy, Colon, Sigmoid/surgery, Colonic Diseases/etiology, Colonic Diseases/surgery, Diverticulitis, Colonic/complications, Female, Follow-Up Studies, Humans, Intestinal Fistula/etiology, Intestinal Fistula/surgery, Laparoscopy/utilization, Length of Stay/statistics & numerical data, Male, Time Factors, Urinary Bladder Fistula/etiology, Urinary Bladder Fistula/surgery, Vaginal Fistula/etiology, Vaginal Fistula/surgery
Pubmed
Web of science
Création de la notice
07/10/2014 13:46
Dernière modification de la notice
20/08/2019 15:29
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