McConnell D B, Sasaki T M, Vetto R M
Am J Surg. 1980 Jul;140(1):80-4. doi: 10.1016/0002-9610(80)90421-3.
Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstruction. When criteria are met, a one-stage procedure is safe. The two-stage approach should enjoy wider application, with the three-stage approach reserved for patients who are unprepared or who have a large pelvic abscess. In patients with colovesical fistula due to cancer, the extent of tumor should be carefully evaluated and resection carried out whenever possible. Colovesical fistulas due to trauma, inflammatory bowel disease and iatrogenic causes are often unusual in location; thus treatment must be individualized.
回顾了过去19年中37例成人结肠膀胱瘘患者的治疗经验。成人结肠膀胱瘘的具体治疗指南受瘘管位置和病因、患者一般状况、盆腔脓肿的存在以及结肠梗阻的存在影响。当符合标准时，一期手术是安全的。二期手术应得到更广泛的应用，三期手术则保留给未做好准备或有巨大盆腔脓肿的患者。对于因癌症导致的结肠膀胱瘘患者，应仔细评估肿瘤范围并尽可能进行切除。由创伤、炎症性肠病和医源性原因导致的结肠膀胱瘘在位置上通常不常见；因此治疗必须个体化。
