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Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
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[Colovesical fistulas : An interdisciplinary challenge].

R Albrecht1, T Weirich2, O Reichelt2

  • 1Klinik für Allgemein-, Viszeral- und Minimal-invasive Chirurgie, HELIOS Klinikum Aue, Gartenstraße 6, 08280, Aue, Deutschland. roland.albrecht@helios-kliniken.de.

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|December 21, 2016
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Summary
This summary is machine-generated.

Minimally invasive surgery for colovesical fistulas is feasible. Effective preoperative diagnostics, including patient history and urinary infection detection, are key for successful laparoscopic repair with a 0% recurrence rate.

Keywords:
BladderDiagnosticsDiverticulitisSigmoid colonTherapy evaluation

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Area of Science:

  • Gastroenterology
  • Urology
  • Surgical Innovation

Background:

  • Colovesical fistulas present significant infection and social burdens.
  • Minimally invasive surgical approaches require effective preoperative diagnostics and interdisciplinary collaboration.
  • The study investigates the feasibility of a minimally invasive surgical approach for colovesical fistulas.

Purpose of the Study:

  • To evaluate the efficacy of preoperative diagnostics for colovesical fistulas.
  • To assess the success of minimally invasive surgical repair in a collaborative surgical and urological setting.
  • To analyze clinical outcomes, complications, and long-term effects of surgical treatment for colovesical fistulas.

Main Methods:

  • Retrospective analysis of 32 patients with suspected colovesical fistula undergoing extensive preoperative diagnostics since 2007.
  • Evaluation of diagnostic tool effectiveness (cystoscopy, CT, colonoscopy) against histopathological findings.
  • Characterization of surgical outcomes, including laparoscopic approach success rates, conversions, and complication rates.

Main Results:

  • Patient history and urinary infection detection were the most reliable diagnostic indicators.
  • Laparoscopic repair was successful in 29 of 32 patients, with 3 conversions to open surgery.
  • Diverticulitis was the primary cause (28 cases); other causes included gynecological and malignant conditions.
  • The disease-related complication rate was 10%, with a 0% recurrence rate.

Conclusions:

  • Laparoscopic repair of colovesical fistulas is achievable in most cases, particularly with preoperative ureteral stenting.
  • A combination of significant patient history, urinary infection detection, and one additional diagnostic measure supports a laparoscopic approach.
  • Minimally invasive surgery offers a viable and effective treatment option for colovesical fistulas, with excellent long-term outcomes.