Introduction: According to literature, colonic resection with a primary anastomosis and no defunctioning ileostomy is a safe treatment for colovesical or colovaginal fistula of diverticular origin. This study investigates the outcome of surgery for this patient group in a regional hospital.
Methods: Patients were obtained from a prospective database in the period 2004-2011. Several variables were investigated for their relation with surgical outcome.
Results: A colovesical (n = 35) or colovaginal (n = 5) fistula was diagnosed in 18 men and 22 women. The mean age was 69 years (range, 45-90). A rectosigmoid resection with primary anastomosis was performed in 32 patients. Fourteen patients received a defunctioning ileostomy. Eight patients were treated with a Hartmann procedure. Overall 30-day treatment-related morbidity and mortality was 48 and 8 %, respectively. Major morbidity, because of anastomotic leakage, was mainly observed in the primary anastomosis group without a defunctioning ileostomy. Morbidity and mortality were associated with high body mass index, diabetes, use of corticosteroids, and American Society of Anesthesiologists classification, though not significantly.
Conclusions: One should be liberal in the use of a defunctioning ileostomy in case of a primary anastomosis after colonic resection for a diverticular fistula, in order to prevent high morbidity rates due to anastomotic leakage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11605-012-1919-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Reconstruction of Abdominal Defects After Open Abdomen Treatment Using Propeller Flaps of the Superior and Deep Inferior Epigastric Artery System: Report of Two Cases.
Microsurgery
January 2025
Division of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Open abdomen treatment (OAT) is associated with significant morbidity and mortality. In cases where primary or delayed fascial closure cannot be achieved, vacuum-assisted wound closure and mesh-mediated fascial traction are indicated, which often result in a planned ventral hernia. If secondary skin closure is not feasible, common treatment of granulated abdominal defects involves split-thickness skin-grafting or healing by secondary intention leading to significant scarring and sometimes mutilating defects.
View Article and Find Full Text PDFNegative-Pressure Wound Therapy: A Novel Approach for Terminal Ileum Anastomosis Success.
Am J Case Rep
January 2025
Department of General Surgery, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia.
BACKGROUND Terminal ileum (TI) anastomoses present challenges due to anatomical features and pressure from the ileocecal valve (ICV). The use of negative-pressure wound therapy (NPWT) is commonly used to treat chronic skin ulcers. Its use for temporary abdominal closure following anastomosis is controversial but has shown promise in patients with inflammatory or vascular disease.
View Article and Find Full Text PDFA Case of Problem-Free Survival Five Years After Abdominal Aortic Sigmoid Colon Fistula Surgery.
Cureus
December 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
An a (AEF) is a rare but life-threatening condition where an abnormal connection forms between the aorta and the gastrointestinal tract, most commonly the duodenum. It can be primary (arising spontaneously due to an aortic aneurysm or infection) or secondary (complicating prior vascular surgery). Immediate recognition and surgical intervention are critical to manage severe gastrointestinal bleeding and prevent fatal outcomes.
View Article and Find Full Text PDFA comparative analysis of lumboperitoneal shunt outcomes in patients with post-hemorrhagic and post-traumatic hydrocephalus.
Sci Rep
January 2025
Department of Neurosurgery, Xichang Peoples' Hospital, Liangshan, Sichuan, People's Republic of China.
Hydrocephalus, whether arising from post-hemorrhagic or post-traumatic origins, poses significant challenges in clinical management. Lumboperitoneal shunting (LPS) emerges as a viable therapeutic intervention, yet comparative analyses between these etiologies remain scarce. This retrospective study aims to compare the efficacy and safety of LPS placement in patients with post-hemorrhagic (PHH) and post-traumatic hydrocephalus (PTH).
View Article and Find Full Text PDFThis study aims to mine and analyze adverse events (AEs) of Vedolizumab based on the FAERS database to better understand its safety and potential risks in the real world. Data from the second quarter of 2014 to the third quarter of 2023 were collected, employing various signal mining methods such as Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM). The study gathered 14,753,012 reports of AEs, of which 46,726 were related to Vedolizumab.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!