[Treatment of colovesical fistula: predictive factors of the maintenance of long-term digestion continuity].

AIM OF THE STUDY: Colovesical fistulas (CVF) may occur in inflammatory or tumoral pelvic diseases. The aim of this study was to analyze the surgical management of patients with a CVF in order to define predictive factors of good results and long term digestive continuity.

PATIENTS AND

METHODS

From 1989 to 1999, this retrospective study included 37 patients, 19 men and 18 women, mean age: 69 years (range 37-93 years). Main etiologies were colonic diverticulitis (n = 22) in 60% of the patients, cancer (n = 6) in 16%, previous radiotherapy (n = 5) in 14%. Treatment was a diverting colostomy in 13 cases, a colectomy in 24 cases without diverting colostomy in 10 cases.

RESULTS

Overall postoperative mortality rate was 16%. With a mean follow-up of 47 months, digestive continuity was restored in 40% of the patients (100% in ASA 1 patients, 55% in ASA 2, 19% in ASA 3 and 0% in ASA 4).

CONCLUSIONS

Our study suggests that long term digestive continuity following surgical treatment of colovesical fistulas does not depend upon etiology or surgical treatment but mainly upon the patient's ASA score.