评估结肠阴道瘘的手术治疗及疗效。
Evaluating surgical management and outcomes of colovaginal fistulas.
作者信息
Wen Yuxiang, Althans Alison R, Brady Justin T, Dosokey Eslam M G, Choi Dongjin, Nishtala Madhuri, Delaney Conor P, Steele Scott R
机构信息
Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Department of Surgery, Division of Colorectal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
出版信息
Am J Surg. 2017 Mar;213(3):553-557. doi: 10.1016/j.amjsurg.2016.11.006. Epub 2016 Nov 14.
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.
CONCLUSION
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.
背景
结肠阴道瘘是一种罕见疾病，伴有严重的发病率。关于结肠阴道瘘修复的文献较少。我们介绍了我们机构治疗结肠阴道瘘的经验。
方法
对2005年至2015年间接受结肠阴道瘘手术治疗的所有患者进行回顾性研究。回顾了患者的人口统计学资料、术中细节和术后结果。
结果
我们确定了27例患者，平均年龄71岁（±13岁），体重指数30（±9）。瘘管最常见的病因是憩室炎（n = 24，89%）。19例患者（70%）采用腹腔镜手术，8例患者（30%）采用开放手术，其中8例患者由腹腔镜手术转为开放手术（42%）。平均随访18个月（±21个月），无复发。
结论
我们展示了最大系列的结肠阴道瘘手术治疗之一。尽管我们的中转率较高，但我们建议在可行时采用腹腔镜手术。
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